输尿管软镜一次性手术与预置输尿管支架后计划性二次手术治疗输尿管结石的临床效果比较

Comparison of the Clinical Effect of One-time Operation with Ureteral Flexible Scope and Planned Second Operation after Presetting Ureteral Stent in the Treatment of Ureteral Calculi

目的:比较输尿管软镜一次性手术与预置输尿管支架后计划性二次手术治疗输尿管结石的临床效果。方法:选取2021年10月—2022年10月拟于扬州大学附属泰州第二人民医院行狄激光碎石术的输尿管结石患者77例作为研究对象,采用随机数表法将其分成对照组(n=32)与观察组(n=45)。两组均接受狄激光碎石术,对照组采用输尿管软镜一次性手术,观察组采用预置输尿管支架后计划性二次手术。比较两组手术成功率、清石率、感染率、并发症发生率、手术相关指标(手术时间、住院时间、住院费用)及生活质量。结果:观察组手术成功率、清石率高于对照组,差异有统计学意义(P<0.001);两组感染率比较,差异无统计学意义(P>0.05)。两组并发症总发生率比较,差异无统计学意义(P>0.05)。观察组手术时间短于对照组,住院费用高于对照组,差异有统计学意义(P<0.05);两组住院时间比较,差异无统计学意义(P>0.05)。治疗后,两组生理职能、心理职能、社会功能、物质情况评分升高,观察组高于对照组,差异有统计学意义(P<0.05)。结论:预置输尿管支架后计划性二次手术治疗输尿管结石的效果优于输尿管软镜一次性手术,能够提高手术成功率,缩短手术时间,加速术后恢复,提高生活质量,且未增加并发症发生风险,但住院费用较高。

Objective:To compare the clinical effect of one-time operation with ureteral flexible scope and planned second operation after presetting ureteral stent in the treatment of ureteral calculi.Methods:A total of 77 patients with ureteral calculi who were scheduled to undergo dilaser lithotriptation in Taizhou Second People's Hospital Affiliated to Yangzhou University were selected as the study objects from October 2021 to October 2022,and were divided into control group(n=32)and observation group(n=45)by random number table method.Both groups received dilaser lithotripia,the control group received one time operation with ureteral soft scope,and the observation group received a planned second operation after preset ureteral stent.The operation success rate,stone removal rate,infection rate,complication rate,operation related indexes(operation time,hospital stay,hospital cost)and quality of life were compared between the two groups.Results:The operation success rate and stone removal rate in observation group were higher than those in control group,the difference was statistically significant(P<0.001).There was no significant difference in infection rate between the two groups(P>0.05).There was no significant difference in the total incidence of complications between the two groups(P>0.05).The operation time of the observation group was shorter than that of the control group,and the hospitalization cost was higher,the difference was statistically significant(P<0.05).There was no significant difference in hospital stay between the two groups(P>0.05).After treatment,the scores of physiological function,psychological function,social function and material condition of the two groups increased,and the observation group was higher than the control group,the difference was statistically significant(P<0.05).Conclusion:The effect of planned second operation after presetting ureteral stent in the treatment of ureteral calculi is better than that of one-time operation with ureteral soft lens,which can improve the success rate of operation,shorten the operation time,accelerate postoperative recovery and improve the quality of life without increasing the risk of complications,but the hospitalization cost is high.