输尿管软镜联合可弯曲负压吸引鞘治疗肾结石的疗效观察

Effect observation of flexible ureteroscope combined with bendable negative pressure suction sheath in the treatment of patients with renal calculus

目的观察逆行肾内输尿管软镜碎石术(RIRS)联合可弯曲负压吸引鞘治疗直径2~3 cm肾结石的疗效。方法将59例肾结石患者分为RIRS组(n=28)和联合组(n=31)。RIRS组采用RIRS治疗,联合组采用RIRS和可弯曲负压吸引鞘治疗。比较2组患者的结石清除率、手术时间、术中失血量、术后住院时间、术后血尿持续时间和术后感染发生率。结果RIRS组手术时间、术中失血量大于或长于联合组,差异有统计学意义(P<0.05)。联合组即刻清石率、术后4周清石率分别为77.42%(24/31)、96.77%(30/31),高于RIRS组的7.14%(2/28)、71.42%(20/28),差异有统计学意义(P<0.05)。RIRS组和联合组均无术后大出血,但联合组术后血尿持续时间更短,术后感染发生率更低,差异有统计学意义(P<0.05)。结论在处理直径2~3 cm的肾结石时,RIRS联合可弯曲负压吸引鞘的清石率更高,手术时间更少,术后并发症更少,感染发生率更低。

Objective To observe the effect of retrograde intrarenal ureteroscopic lithotripsy(RIRS)combined with bendable negative pressure suction sheath in the treatment of renal calculus with a diameter of 2 to 3 cm.Methods A total of 59 patients with renal calculus were divided into RIRS group(n=28)and combined group(n=31).The RIRS group was treated with RIRS,and the combined group was treated with RIRS and bendable negative pressure suction sheath.The stone clearance rate,operation time,intraoperative blood loss,postoperative hospitalization time,postoperative hematuria duration and postoperative infection rate were compared between the two groups.Results The operation time and intraoperative blood loss in the RIRS group were significantly higher or longer than those in the combined group(P<0.05).The immediate stone clearance rate and the stone clearance rate at 4 weeks after operation in the combined group were 77.42%(24/31)and 96.77%(30/31)respectively,which were significantly higher than 7.14%(2/28)and 71.42%(20/28)in the RIRS group(P<0.05).No postoperative massive hemorrhage occurred in both the RIRS group and the combination group,but the postoperative hematuria duration in the combination group was significantly shorter,and the postoperative infection rate was significantly lower(P<0.05).Conclusion When treating renal calculus with a diameter of 2 to 3 cm,RIRS combined with bendable negative pressure suction sheath has a higher stone clearance rate,less operation time,fewer postoperative complications and lower infection rate.