硕通镜与软镜治疗输尿管上段结石对照研究

Comparison of Shuotong Ureterosopy and Flexible Ureterosopy for Lithotripsy

目的比较分析硕通镜碎石术与输尿管软镜碎石术治疗10mm<直径≤20mm的输尿管上段结石的临床应用效果。方法选取2018年7月~2019年12月输尿管上段结石10mm<直径≤20mm的患者115例作为研究对象,随机选择其中的55例采用硕通镜碎石术进行治疗(观察组),另外的60例采用输尿管软镜碎石术治疗(对照组),比较观察两组患者的手术相关指标,其中包括手术时间、术后住院天数、术后1天及术后1个月清石率、术后并发症发生率等指标的差异,同时记录两组患者术后辅助治疗的情况。结果两组手术均成功完成,在手术时间方面,两组差异无统计学意义(40.52±10.19min vs 41.01±9.20min,P>0.05);在术后住院天数方面,两组差异无统计学意义(4.04±1.72天vs 4.12±1.67天,P>0.05);观察组术后1天结石清除率较对照组高(94.5%vs 80.0%),差异有统计学意义(P<0.05);两组术后1个月结石清除率差异无统计学意义(96.3%vs 96.6%,P>0.05);观察组术后总并发症发生率低于对照组(5.45%vs 18.33%),术后辅助治疗较对照组少(7.27%vs 23.33%),差异均有统计学意义(P均<0.05)。结论硕通镜碎石术与输尿管软镜碎石术都可以成为10mm<直径≤20mm输尿管上段结石的有效治疗方法,但硕通镜碎石术结石清除率高、并发症少、创伤小、更加具有微创优势,在临床上值得推广。

Objective To compare the safety and efficacy of upper ureteral calculi treated by shuotong lithotropsy and flexible ureteroscope lithotripy,our study provides a new idea for the treatment of upper ureteral calculi.Methods All the cases with shuotong ureteroscopy or flexble ureteroscopy with complete clinical data in the hospital during July 2018 to December 2019 were collected,total 115 cases.All the patients were upper ureteral calculi with 10mm<diameter≤20mm.The operation time,postoperative hospitalization days,complications,calculi clearance rate,postoperative adjuvant therapy of two groups were compared.Results For the two groups,the difference of the average operation time and the average postoperative hospitalization days were neither statistically significant.Calculi clearance rate 1day were 94.5%and 80.0%respectively,and the difference was significant(P<0.05).Calculi clearance rate 1month were 96.3%and 96.6%respectively,and the difference was not significant(P>0.05).The difference of total complicantions and postoperative adjuvant therapy were both statistically significant.Conclusion Compared with flexble ureteroscopy,shuotong ureteroscopy is safer with higher comfort and better effect.In clinical of upper ureteral calculi with a 10mm<diameter≤20mm,shuotong ureteroscopy should be given priority.