小儿双通道输尿管镜治疗输尿管上段结石的临床研究

Clinical study of a kind of dual-channel ureteroscopy for treatment of upper ureteral calculi in children

目的观察小儿双通道输尿管镜在输尿管上段结石钬激光碎石术中的临床疗效。方法2020年4月~2020年12月我院收治的单侧输尿管结石病人80例,均行手术治疗。根据治疗方式分为两组,实验组40例,采用小儿双通道输尿管镜治疗;对照组40例,采用常规单通道输尿管镜治疗,比较两组病人的进镜成功率、手术时间、术后是否出现发热,结石逃逸率以及结石清除率。结果实验组进镜成功率(100%)高于对照组(77.5%),差异有统计学意义(P<0.05)。实验组结石逃逸率(2.5%)远低于对照组(32.5%),差异有统计学意义(P<0.05)。实验组术后发热率(2.5%)低于对照组(20.0%),差异有统计学意义(P<0.05)。实验组手术时间为(31.8±2.23)分钟,对照组为(48.6±3.71)分钟,两组比较差异有统计学意义(P<0.05)。实验组的结石清除率(100%)高于对照组(80%),差异有统计学意义(P<0.05)。结论小儿双通道输尿管镜操作简单,在碎石过程中视野清晰,可持续碎石,手术时间短,结石逃逸率低,碎石效率高,术后并发症少,且价格不高。

Objective To introduce the advantages of a kind of dual-channel ureteroscope in the treatment of holmium laser lithotripsy for upper ureteral calculi in children.Methods 80 cases with unilateral ureteral calculi admitted to our hospital from April 2020 to December 2020 were retrospectively analyzed.40 patients in the experimental group were treated with pediatric dual-channel ureteroscopy for holmium laser lithotripsy,and other 40 patients in the control group were treated with conventional single-channel ureteroscopy for holmium laser lithotripsy.Compared the success rate of ureteroscopy insertion,operation time,postoperative fever and other complications,escape rate and clearance rate of alculi.Result The ureteroscope was successfully inserted in all the patients of the experimental group(100%vs 77.5%),the difference was statistically significant(P<0.05).Experimental calculi escape rate(2.5%)is far lower than the control group(32.5%),the difference was statistically significant(P<0.05).Experimental operation time for(31.8±2.23)minutes,and the control group(48.6±3.71)minutes,the more similar between the two groups was statistically significant(P<0.05).Experimental group of stone clearance rate(100%)than the control group(80%),difference was statistically significant(P<0.05).Conclusion Dual-channel reteroscopy is simple in operation,with clear field of vision in the process of lithotripsy,short operation time,low stone escape rate,high lithotripsy efficiency,less postoperative complications,and low price.