输尿管硬镜结合导引鞘联合组合式软镜治疗肾盂结石的临床研究

Clinical Study on Rigid Ureterscope and Guide Sheath Combined with Modular Flexible Ureterscope in the Treatment of Renal Pelvic Calculi

目的 探讨输尿管硬镜结合导引鞘联合组合式软镜钬激光碎石治疗肾盂结石的效果。方法 将我院2019年1月至2021年3月收治的92例较大肾盂结石(2~3 cm)患者随机平均分为两组。实验组先经导引鞘下输尿管硬镜钬激光碎石,再用组合式输尿管软镜钬激光碎石,对照组行经导引鞘下组合式输尿管软镜钬激光碎石。对比两组的手术时间、术中软镜使用时间、术后住院时间、 1个月后结石排净率、住院费用及并发症情况。结果 实验组的手术时间及术中软镜使用时间短于对照组(P<0.05)。两组的术后住院时间、 1个月后结石排净率及住院费用比较无统计学差异(P>0.05)。实验组并发症发生率低于对照组(P<0.05)。结论 输尿管硬镜结合导引鞘联合组合式软镜治疗2~3 cm较大肾盂结石是一种安全、有效的方法,值得临床推广应用。

Objective To explore the effect of rigid ureterscope and guide sheath combined with modular flexible ureterscope holmium laser lithotripsy in the treatment of renal pelvic calculi.Methods 92 cases of patients with renal pelvic calculi(2 to 3 cm)admitted to our hospital from January 2019 to March 2021 were randomly divided into two groups equally.The experimental group was given rigid ureterscope holmium laser lithotripsy through guide sheath,then the modular flexible ureterscope holmium laser lithotripsy.The control group was given modular flexible ureterscope holmium laser lithotripsy through guide sheath directly.The operation time,intraoperative use time of flexible ureterscope,postoperative hospitalization time,stone clearance rate after 1 month,hospitalization expenses and complications were compared between the two groups.Results The operation time and intraoperative use time of flexible ureterscope in the experimental group were shorter than those in the control group(P<0.05).No statistical difference was found in the postoperative hospitalization time,stone clearance rate after 1 month,and hospitalization expenses between the two groups(P>0.05).The incidence of complications in the experimental group was lower than that in the control group(P<0.05).Conclusions Rigid ureterscope and guide sheath combined with modular flexible ureterscope is a safe and effective method in the treatment of renal pelvic calculi(2 to 3 cm),which is worthy of clinical promotion and application.