可智能监控肾盂内压的输尿管软镜碎石术在泌尿系结石患者中的应用效果

Application of soft ureteroscopic lithotripsy with intelligent monitoring of intrapelvic pressure in patients with urinary calculi

目的探讨可智能监控肾盂内压的输尿管软镜碎石术在泌尿系结石患者中的应用效果。方法选取2019年1月至2021年1月石狮市医院接受治疗的185例泌尿系结石患者,采用随机数表法分为试验组(n=93)和对照组(n=92)。对照组给予输尿管软镜碎石术治疗,试验组在对照组的基础上给予可智能监控肾盂内压治疗。比较两组围手术期情况、肾盂压力、尿素氮(BUN)、血肌酐(Scr)、24 h尿蛋白定量(24 h UP)、最大尿流量(Qmax)、残余尿量(RUV)、达到Qmax的逼尿肌压(Pdet_(Qmax))、结石清除率及术后并发症发生率。结果试验组患者手术时间、术中出血量、膀胱冲洗时间、尿管留置时间及术后住院时间均显著低于对照组(P<0.05);术前,试验组和对照组肾盂压力、肾功能检查结果比较,差异无统计学意义(P>0.05);术后,试验组和对照组肾盂压力均明显升高,且试验组高于对照组,BUN、Scr及24 h UP均显著降低,且试验组低于对照组,差异有统计学意义(P<0.05);术前,试验组和对照组尿道功能比较,差异无统计学意义(P>0.05);术后,两组Qmax水平明显升高,RUV、Pdet_(Qmax)水平明显降低(P<0.05),但术后两组间比较,差异无统计学意义(P>0.05);试验组一次清除率、二次清除率均显著高于对照组,差异有统计学意义(P<0.05),但术后3个月清除率两组间比较差异无统计学意义(P>0.05);两组手术并发症总发生率分别为4.30%、14.13%,差异有统计学意义(P<0.05)。结论在泌尿系结石患者中应用可智能监控肾盂内压的输尿管软镜碎石术效果显著,可有效改善患者肾盂压力、肾功能水平。

Objective To study Application of soft ureteroscopic lithotripsy with intelligent monitoring of intrapelvic pressure in patients with urinary calculi.Methods A total of 185 patients with urinary calculi treated in Shishi City Hospital from January 2019 to January 2021 were selected and divided into experimental group(n=93)and control group(n=92)by random number table method.The control group was treated with soft ureteroscope lithotripsy,and the experimental group was treated with intelligent monitoring of intraperitoneal pressure on the basis of the control group.Perioperative situation,renal pelvis pressure,urea nitrogen(BUN),serum creatinine(Scr),24-hour urinary protein quantity(24 h UP),pressure at maximum(Qmax),residual urine volume(RUV),DEtrusor pressure up to Qmax(Pdet_(Qmax)),stone clearance rate and incidence of postoperative complications were compared between the two groups.Results Operation time,intraoperative blood loss,bladder flushing time,catheter indwelling time and postoperative hospital stay in experimental group were significantly lower than those in control group(P<0.05).Before surgery,there was no statistical significance in renal pressure and renal function between the experimental group and the control group(P>0.05).After surgery,renal pelvis pressure of experimental group and control group was significantly increased,and experimental group was higher than control group,BUN,Scr and 24 h UP were significantly decreased,and experimental group was lower than control group,the difference was statistically significant(P<0.05).Before operation,there was no significant difference in urethral function between the experimental group and the control group(P>0.05).After surgery,the Qmax levels of the two groups were significantly increased,ant the RUV and Pdet_(Qmax)levels were significantly decreased(P<0.05),but there was no significant difference between the two groups(P>0.05).The primary clearance rate and secondary clearance rate of the experimental group were significantly higher than those of the control group,with statistical significance(P<0.05),but there was no statistical significance in clearance rate between the two groups 3 months after surgery(P>0.05).The total incidence of surgical complications in the two groups was 4.30%and 14.13%,the difference was statistically significant(P<0.05).Conclusion Soft ureteroscope lithotripsy,which can monitor the pressure of the renal pelvis intelligently,can improve the pressure of the renal pelvis and the level of renal function effectively in patients with urinary calculi.