日间手术模式下开展老年患者输尿管软镜碎石的疗效与安全性

Safety and efficacy of flexible ureteroscopic lithotripsy in day surgery for elderly patients

回顾性收集2021年5月至2022年10月北京医院接受输尿管软镜碎石取石术(FURL)的老年患者的临床资料,选取上尿路结石患者160例,根据手术模式分为日间手术模式组和传统住院手术模式组各80例,评估两种模式的疗效和安全性。日间手术模式组和传统住院手术模式组的结石完全清除率[91.3%(73/80)比90.0%(72/80)]、手术时长[60.0(41.0,90.0)min比61.0(50.0,96.5)min]和术后全身炎症反应综合征发生率[8.8%(7/80)比12.5%(10/80)]比较差异无统计学意义(χ^(2)=0.07,Z=-1.28,χ^(2)=0.59;P>0.05),试验组较对照组的术后住院时长[5.0(5.0,6.0)h比18.0(16.2,30.0)h]明显缩短、总住院花费[(20696.7±4645.5)元与(31030.8±6275.1)元]明显降低,差异有统计学意义(Z=-10.16,t=-11.85;P<0.05)。结果提示输尿管软镜日间手术在外科加速康复理念的指导和合理高效的运行下,老年患者的恢复和花费更有优势。

The clinical data of 160 elderly patients with upper urinary tract stones who underwent flexible ureteroscopic lithotripsy(FURL)in Beijing Hospital from May 2021 to November 2022 were retrospectively analyzed,including 80 patients with ambulatory surgery(study group)and 80 patients with the traditional surgery(control group).The efficacy and safety were compared between two groups.There were no significant differences in the rate of complete stone removal(91.3%(73/80)vs.90.0%(72/80),P>0.05),operation time(60.0(41.0,90.0)min vs.61.0(50.0,96.5)min,P>0.05),and incidence of postoperative systemic inflammatory response syndrome(SIRS)(8.8%(7/80)vs.12.5%(10/80),P>0.05)between two groups,while the postoperative length of hospital stay(5.0(5.0,6.0)h vs.18.0(16.2,30.0)h,P<0.05)was shorter and the medical expenses((20696.7±4645.5)Yuan vs.(31030.8±6275.1)Yuan,P<0.05)was less in the study group than those in the control group.The study indicates that the day surgery mode of flexible ureteroscopic lithotripsy has advantages of faster recovery and less cost over the traditional surgery mode for elderly patients.