双套管可视输尿管鞘联合一次性输尿管软镜治疗直径>2 cm上尿路结石的临床研究

Clinical Study of Double-tube Visual Ureteral Sheath Combined with Single-use Flexible Ureteroscope in the Treatment of Upper Urinary Tract Calculus with Diameter>2 cm

目的:比较双套管可视输尿管鞘与普通输尿管鞘下一次性输尿管软镜碎石术治疗直径>2 cm上尿路结石的安全性和有效性。方法:选取2021年1月—2022年12月江西医学高等专科学校第一附属医院收治的80例直径>2 cm上尿路结石患者,按随机数字表法分为试验组与对照组,各40例。试验组行双套管可视输尿管鞘下一次性输尿管软镜碎石术,对照组行普通输尿管鞘下一次性输尿管软镜碎石术。比较两组置鞘成功率、手术时间、术后住院时间、结石清除率、手术并发症。结果:两组术后住院时间、手术并发症发生率及术后1、3个月结石清除率比较,差异均无统计学意义(P>0.05),试验组手术时间短于对照组,置鞘成功率、术后即刻结石清除率均高于对照组,差异均有统计学意义(P<0.05)。结论:相比普通输尿管鞘,双套管可视输尿管鞘一次性输尿管软镜治疗>2 cm上尿路结石的效果更佳,其手术时间更短,术后即刻结石清除率更高,且安全性高。

Objective:To compare the safety and efficacy of double-tube visual ureteral sheath and common ureteral sheath single-use flexible ureteroscope lithotripsy in the treatment of upper urinary tract calculus with diameter>2 cm.Method:A total of 80 patients with upper urinary tract calculus with diameter>2 cm admitted to the First Affiliated Hospital of Jiangxi Medical College from January 2021 to December 2022 were selected and divided into experimental group and control group according to random number table method,with 40 cases in each group.The experimental group underwent double-tube visual ureteral sheath single-use flexible ureteroscope lithotripsy and the control group underwent common ureteral sheath single-use flexible ureteroscope lithotripsy.The success rate of sheath placement,operation time,postoperative hospital stay,stone clearance rate and operative complications were compared between the two groups.Result:There were no significant differences in postoperative hospital stay,incidence of operative complications,1 month and 3 months after operation of stone clearance rate between the two groups(P>0.05).The operation time of experimental group was shorter than that of control group,and the success rate of sheath placement and immediate postoperative stone clearance rate of experimental group were higher than those of control group,the differences were statistically significant(P<0.05).Conclusion:Compared with common ureteral sheath,double-tube visual ureteral sheath single-use flexible ureteroscope lithotripsy is more effective in the treatment of upper urinary tract calculus with diameter>2 cm,which with shorter operation time,higher immediate postoperative stone clearance rate and high safety.