7.5 Fr和9.5 Fr输尿管软镜一期治疗直径<2.0 cm上尿路结石的安全性和有效性比较

Comparison of Safety and Effectiveness between 7.5 Fr and 9.5 Fr Ureteroscopic Primary Treatment for Upper Urinary Tract Stones with a Maximum Diameter 2.0 cm

目的探讨7.5 Fr、9.5 Fr输尿管软镜一期治疗直径<2.0 cm上尿路结石的安全性与有效性。方法本研究为前瞻性随机对照研究,纳入邵武市立医院2022年4月至2023年4月接受输尿管镜手术治疗的上尿路结石患者,观察组使用7.5 Fr输尿管软镜,对照组使用9.5 Fr输尿管软镜。比较两组手术一般情况、结石清除率、输尿管损伤、手术并发症。结果共纳入70例患者,两组各35例。两组碎石时间、手术时间、住院时间对比,差异无统计学意义。观察组与对照组结石清除率比较,差异无统计学意义(91.43%vs.94.29%,P=0.643)。观察组和对照组输尿管损伤级别分布比较,差异有统计学意义(P=0.006);其中,观察组0级损伤为主,对照组1级为主。两组血尿、膀胱痉挛、疼痛等发生率比较,差异无统计学意义。结论7.5 Fr和9.5 Fr输尿管软镜一期治疗最大径<2.0 cm上尿路结石均能够达标治疗效果,但采用7.5 Fr输尿管软镜更容易控制输尿管损伤,对患者取得更理想的预后有一定帮助。

Objective To investigate the safety and efficacy of 7.5 Fr and 9.5 Fr ureteral flexible scopes for the one-stage treatment of upper urinary tract stones with a maximum diameter 2.0 cm.Methods This study is a prospective randomized controlled study,which included patients with upper urinary tract stones who received ureteroscopic surgical treatment in Shaowu Municipal Hospital from April 2022 to April 2023,with the observation group using 7.5 Fr ureteral flexible scopes and the control group using 9.5 Fr ureteral flexible scopes.The two groups were compared in terms of general surgical conditions,stone removal rate,ureteral injury,and surgical complications.Results A total of 70 patients were included,35 in each of the two groups.Comparison of lithotripsy time,operation time and hospitalization time between the two groups showed no statistically significant difference.Comparison of stone removal rate between observation and control groups,the difference was not statistically significant(91.43%vs.94.29%,P=0.643).The difference was statistically significant when comparing the distribution of ureteral injury grades in the observation group and the control group(P=0.006);among them,grade 0 injuries were predominant in the observation group and grade 1 was predominant in the control group.Comparison of the incidence of hematuria,bladder spasm,and pain between the two groups showed no statistically significant difference.Conclusions 7.5 Fr and 9.5 Fr ureteral flexible scope one-stage treatment of upper urinary tract stones with a maximum diameter 2.0 cm are both able to achieve the standard therapeutic effect,but the use of 7.5 Fr ureteral flexible scope is easier to control ureteral injuries,which is helpful for the patients to achieve a more satisfactory prognosis.