应用智能控压负压吸引输尿管软镜治疗肾铸型结石的临床研究

Clinical study of intelligent pressure controlled negative pressure suction flexible ureteroscopy in the treatment of renal cast stones

目的:比较智能控压负压吸引输尿管软镜碎石术与普通输尿管软镜碎石术治疗肾铸型结石的临床疗效。方法:回顾性分析2017年9月至2021年8月于重庆医科大学附属第一医院及赣州市人民医院行输尿管软镜碎石术的64名肾铸型结石患者临床资料。其中男性42例,女性22例,平均年龄50.9岁。41例行智能控压负压吸引输尿管软镜碎石术(控压组),23例行普通输尿管软镜碎石术(非控压组)。运用t检验、卡方检验或Fisher确切概率法对2组患者的一期结石清除率、并发症发生率、术后血白细胞、手术时间、住院时间、住院总费用等进行比较。结果:控压组手术时间长于对照组[(78.9±29.8)min vs.(60.7±32.1) min,t=2.278,P=0.026],一期结石清除率高于对照组(73.1%vs. 0%,χ^(2)=28.808,P=0.000),住院总费用低于对照组[(24 215.9±3 848.8)元vs.(26 497.9±4 230.2)元,t=2.196,P=0.032]。2组并发症发生率(19.5%vs. 17.3%,χ^(2)=0.044,P=0.835)、住院时间[(8.22±2.94)d vs.(6.87±1.79)d,t=1.997,P=0.05]、术后血白细胞[(9.83±5.72)×10^(9)个/L vs.(9.06±2.49)×10^(9)个/L,t=0.067,P=0.546]差异均无统计学意义。结论:对于肾铸型结石,智能控压输尿管软镜吸引取石术较普通输尿管软镜一期结石清除率高、住院总费用少、患者获益更高。

Objective:To compare the clinical efficacy of intelligent pressure controlled negative pressure suction flexible ureteroscopic lithotripsy and ordinary flexible ureteroscopic lithotripsy in the treatment of renal cast stones. Methods:The clinical data of 64 patients with renal cast stones who underwent flexible ureteroscopic lithotripsy in The First Affiliated Hospital of Chongqing Medical University and Ganzhou People’s Hospital from September 2017 to August 2021 were analyzed retrospectively. There were 42 males and 22 females,with an average age of 50.9 years. Among them,41 cases underwent intelligent pressure controlled negative pressure suction flexible ureteroscopic lithotripsy( pressure controlled group), and 23 cases underwent ordinary electronic flexible ureteroscopic lithotripsy(non-pressure controlled group). The t test,chi-square test or Fisher’s exact test were used to compare the stone-free rate,incidence of complications,postoperative white blood cells,operation time,hospital stay and total hospitalization cost between the two groups. Results :The operation time in the pressure controlled group was longer than that in the non-pressure controlled group[(78.9±29.8) min vs.(60.7±32.1) min,t=2.278,P=0.026],the stone-free rate was higher than that in the non-pressure controlled group(73.1% vs. 0%, χ^(2)=28.808,P=0.000),and the total hospitalization cost was lower than that of the non-pressure controlled group[(24 215.9±3 848.8) vs.(26 497.9±4 230.2),t=2.196,P=0.032]. There was no significant difference between the two groups in the incidence of complications(19.5% vs. 17.3%, χ^(2)=0.044,P=0.835),the length of hospital stay [(8.22±2.94) d vs.(6.87±1.79) d,t=1.997,P=0.05] and postoperative white blood cells [(9.83±5.72)×10^(9)/L vs.(9.06±2.49)×10^(9)/L,t=0.067,P=0.546]. Conclusion:For renal cast stones,intelligent pressure controlled negative pressure suction flexible ureteroscopic lithotripsy has higher stone-free rate,less total hospitalization cost and higher benefit for patients than ordinary electronic flexible ureteroscopic lithotripsy.