输尿管鞘辅助输尿管镜碎石术治疗输尿管中上段结石的疗效及安全性分析

Efficacy and safety of ureteral sheath-assisted ureteroscopic lithotripsy in the treatment of middle and uppe ureteral calculi

目的探析输尿管鞘辅助输尿管镜碎石术治疗输尿管中上段结石的疗效及安全性。方法回顾性分析东莞市常安医院2019年7月-2021年7月行手术治疗的87例输尿管中上段结石患者的临床资料,按照手术方式的不同分为常规组(n=47)和研究组(n=40),常规组采用无输尿管鞘辅助进行手术治疗,研究组采用输尿管鞘辅助手术治疗。对比2组患者的手术时间、术中出血量、术后住院时间、白细胞升高情况、发热情况及疗效。结果研究组手术时间、术中出血量低于常规组(P<0.05),2组住院时间比较差异无统计学意义(P>0.05);研究组术后发热、白细胞升高发生率低于常规组(P<0.05),2组输尿管损伤发生情况比较差异无统计学意义(P>0.05);研究组患者结石清除率高于常规组,结石上移率低于常规组(P<0.05),2组碎石成功率比较差异无统计学意义(P>0.05)。结论输尿管鞘辅助输尿管镜碎石术可以提高手术效率和结石清除率,减少结石上移发生,且具有较高安全性,值得推广。

Objective To explore the efficacy and safety of ureteral sheath-assisted ureteroscopic lithotripsy in the treatment of middle and upper ureteral calculi.Methods The surgical data of 87 patients with middle and upper ureteral calculi who underwent surgical treatment in the Urology Department of our hospital from July 2019 to July 2021 were retrospectively analyzed,and the patients were divided into a routine group(n=47)and a study group(n=40),the routine group received surgical treatment without ureteral sheath,and the study group received ureteral sheath-assisted surgical treatment.conduct statistical analysis.Results The operation time and intraoperative blood output of the study group were lower than those of the routine group(P<0.05).The length of hospital stay of the two groups was compared(P>0.05);The postoperative fever and leukocyte elevation in the study group were lower than those in the routine group(P<0.05).There was a difference in the incidence of ureteral injury between the two groups(P>0.05);The stone clearance rate in the study group was higher than that in the routine group,and the stone upward movement rate was lower than that in the routine group(P<0.05).There was a significant difference in the success rate of lithotripsy between the two groups(P>0.05).Conclusion The ureteral sheath assists in ureteroscopic lithotripsy,which can improve the operation efficiency and stone clearance rate,reduce the occurrence of upward movement of stones,and has high safety in the operation,and will not lead to the increase of intraoperative and postoperative complications.It has clinical application and promotion significance.