桥接抗凝在斑马软镜肾结石手术中的应用研究

Application of bridging anticoagulation therapy in the treatment of kidney lithiasis by zebra one-used flexible ureteroscopy

目的研究围术期桥接抗凝对接受抗凝治疗的患者接受输尿管软镜肾结石手术的应用价值。方法收集2020年4月~2021年4月间接受斑马软镜碎石术的肾结石患者123例,其中36例因长期口服抗凝/抗血小板制剂而在围术期给予低分子肝素桥接(桥接组),87例未接受抗凝方案(对照组)。对比两组手术时长、术后住院日、清石率及并发症(发热、血尿、膀胱刺激征、腰痛和石街)。结果桥接组仅术后住院日明显长于对照组,差异有统计学意义(P<0.05),手术时长、清石率和并发症比较,差异无统计学意义(P>0.05)。结论在斑马软镜碎石术的围术期对长期抗凝的肾结石病例给予桥接抗凝具备可行性。

Objective To explore the feasibility of perioperative bridging anticoagulation therapy in treatment of renal lithiasis by holmium laser lithotripsy with flexible ureteroscope in patients with continuous anticoagulation.Methods Data of 123 patients with renal calculi received Ho:YAG laser lithotripsy by zebra one-used flexible ureteroscopy from April 2020 to April 2021 were retrospectively analyzed.Among them,36 patients received bridging anticoagulant therapy(bridging group)due to long-term oral anticoagulant/antiplatelet drugs,and 87 patients did not receive anticoagulant therapy(control group).The operation time,postoperative hospital stay,stone clearance rate and complications(fever,hematuria,bladder irritation,renal colic and steinstrasse)were observed and compared between the two groups.Results All operations were accomplished successful in both groups.The postoperative hospital stay in the bridging group was longer than that in the control group(P<0.05),but there was no significant difference in the operation time,stone clearance rate and complications(P>0.05).Conclusion Considering the risk and efficacy,it is safe and effective to carry out bridging anticoagulation treatment on patients with long-term anticoagulant renal lithiasis during the perioperative period by combined zebra one-used flexible ureteroscopy and holmium laser lithotripsy.