自体血凝块技术在输尿管软镜碎石中的应用

Application of autologous blood clot technique in flexible ureteroscopic lithotripsy

目的通过在输尿管软镜联合钬激光碎石手术中应用自体血凝块技术的效果比较来评价自体血凝块技术的适用性和安全性。方法收集2022年6月—2024年2月于蚌埠医科大学第一附属医院行输尿管软镜联合钬激光碎石术的65例结石患者资料进行回顾性分析,按照是否使用自体血凝块技术分为观察组30例、对照组35例。分析并比较2组患者手术时间、术中取石次数、住院时间、术后残留2 mm结石例数、术后残留4 mm结石例数及并发症发生情况等。结果2组患者年龄、性别、BMI、结石数量、结石位置以及累积结石大小差异均无统计学意义(P>0.05)。观察组手术时间[(54.97±7.06)min]较对照组[(68.14±9.75)min]缩短,术中取石次数[(11.50±3.04)次]明显少于对照组[(20.77±3.36)次],术后残留2 mm结石例数(8例)明显少于对照组(22例),差异均有统计学意义(P<0.05)。2组术后残留4 mm结石例数、住院时间及并发症发生率比较差异均无统计学意义(P>0.05)。结论输尿管软镜联合钬激光碎石术中使用自体血凝块技术具有良好的适用性及安全性。能够缩短手术时间,减少术中取石次数,提高术后无结石率,使得临床无意义残余结石碎片的发生率最小化,从而可能降低结石复发率。

Objective To evaluate the suitability and safety of autologous blood clot technique in flexible ureteroscopy combined with the holmium laser lithotripsy.Methods A retrospective analysis of 65 patients with ureteral calculi in the First Affiliated Hospital of Bengbu Medical University who underwent flexible ureteroscopy combined with the holmium laser lithotripsy was performed from June 2022 to February 2024.They were divided into two groups according to whether autologous blood clot technology was used or not:30 cases in observation group and 35 cases in control group.The operative duration,the number of stone removal during operation,duration of hospital stay,the number of residual 2 mm stones,the number of residual 4 mm stones and complications were recorded for statistical analysis.Results There were no significant differences in age,sex,BMI,stone number,stone location and cumulative stone size between the two groups(P>0.05).The operation time of the observation group[(54.97±7.06)min]was shorter than that of the control group[(68.14±9.75)min],the number of intraoperative stone removal[(11.50±3.04)times]was significantly less than that of the control group[(20.77±3.36)times],and the number of cases of residual 2 mm stones after operation(8 cases)was significantly less than that of the control group(22 cases),and the differences were all statistically significant(P<0.05).The number of residual 4 mm stones,duration of hospital stay and complications were insignificantly different(P>0.05).Conclusion The use of autologous blood clot technique has good applicability and safety in flexible ureteroscopy combined with the holmium laser lithotripsy.It could shorten the operation time,reduce the number of stone removal during operation,improve the postoperative stone free rate,and minimize the incidence of clinically insignificant residual fragments,potentially reduce stone recurrence.