一次性电子输尿管软镜和可重复使用纤维输尿管软镜治疗老年上尿路结石的效果及安全性比较

Comparison of efficacy and safety between single⁃use digital flexible ureteroscope and reusable fiber⁃optic flexible ureteroscope in the treatment of elderly patients with upper urinary tract calculi

目的 观察一次性电子输尿管软镜(single-use digital flexible ureteroscope, SDFU)和可重复使用纤维输尿管软镜(reusable fiber-optic flexible ureteroscope, RFFU)治疗老年上尿路结石的效果及安全性。方法 本研究采取前瞻性、单盲2、单中心随机对照的试验方法。纳入2020年6月—2022年1月于西南医科大学附属成都三六三医院治疗的老年上尿路结石患者82例,随机分为SDFU组和RFFU组。SDFU组接受一次性电子输尿管软镜钬激光碎石治疗,RFFU组接受可重复使用纤维输尿管软镜钬激光碎石治疗。观察并比较2组围术期指标值、结石清除情况、实验室指标值及术后并发症。结果 SDFU组手术时间、碎石时间少于RFFU组,术后结石清除率高于RFFU组,差异均有统计学意义(P<0.05)。术后,2组血肌酐水平较同组术前升高(P<0.05), 2组血肌酐水平和血红蛋白水平差异无统计学意义(P>0.05)。2组患者术后并发症以GradeⅠ、Ⅱ级为主,并发症总发生率差异无统计学意义(P>0.05)。结论 SDFU与RFFU治疗老年上尿路结石均具有良好效果,安全性高;但SDFU手术时间、碎石时间更短,术后结石清除率更高。

Objective To investigate the efficacy and safety of single⁃use digital flexible ureteroscope(SDFU)and reus⁃able fiber⁃optic flexible ureteroscope(RFFU)in the treatment of elderly patients with upper urinary tract calculi.Methods A prospective,single⁃blind,single⁃center randomized controlled trial was adopted in this study.82 elderly patients with upper uri⁃nary calculi treated in Chengdu 363 Hospital Affiliated to Southwest Medical University from June 2020 to January 2022 were enrolled and randomly divided into SDFU group and RFFU group.The SDFU group received holmium laser lithotripsy with SDFU,while the RFFU group received holmium laser lithotripsy with RFFU.The perioperative indexes,stone clearance,labo⁃ratory indexes and postoperative complications were observed and compared between the two groups.Results The operation time and lithotripsy time of the SDFU group were shorter than those of the RFFU group,and the postoperative stone clearance rate was higher than that of the RFFU group,with statistical significance(P<0.05).After surgery,the blood creatinine level of the two groups increased compared to the same group before surgery(P<0.05),and there was no statistically significant difference in the levels of blood creatinine and hemoglobin between the two groups(P>0.05).The postoperative complica⁃tions were mainly GradeⅠand GradeⅡ,and there was no statistical significance in the total incidence of complications be⁃tween the two groups(P>0.05).Conclusion Both SDFU and RFFU are effective and safe in the treatment of elderly pa⁃tients with upper urinary tract calculi.However,the operation time and lithotripsy time with SDFU is shorter,and the postoper⁃ative stone clearance rate is higher.