一次性电子输尿管软镜治疗肾下盏结石疗效分析:单中心回顾性研究

Efficacy and Safety of Disposable Flexible Ureteroscope in Treatment of Renal Stones:Single Center-Based Retrospective Study

目的观察一次性电子输尿管软镜治疗肾下盏结石的安全性及有效性。方法回顾性分析2020年7月至2023年8月,肾下盏结石患者245例的临床资料。均在一次性电子输尿管软镜下行钬激光碎石治疗,碎石能量0.6~1.2J,频率20~50Hz,光纤直径200μm或365μm。记录患者围期手术指标包括手术时间、住院时间、手术成功率,术后4周随访,检测碎石清除情况,同时记录术中和术后并发症发生情况。结果本研究245例患者,手术成功率98.4%(241/245);4例出现输尿管狭窄置管后择期碎石成功;1例术中出现一次性电子软镜损害,更换复用性软镜手术成功。手术时间平均(42.9±11.5)min,术后住院时间平均(4.05±1.1)d。术后4周结石清除率97.9%(236/241)。术后所有患者均出现轻度血尿,14例发生低热(<38.5℃);1例发生高热(39.7℃),所有患者无输尿管损伤、感染性休克等严重并发症发生。结论一次性电子软镜可以安全、有效地处理肾下盏结石,操作简便、视野清晰,避免了重复使用软镜治疗肾下盏结石的损耗。具有一定的临床应用价值。

Objective To observe the safety and efficacy of disposable flexible ureteroscope in the treatment of lower calyceal calculi.Methods A retrospective analysis on the clinical data of 245 patients with renal pelvis stones treated between Jul.2020 and Aug.2023 was made.All the patients were given Holmium laser lithotripsy under a disposable electronic ureteroscope with a lithotripsy energy of 0.6-1.2 J and a frequency of 20-50 Hz.The diameter of the laser fiber was either 200μm or 365μm.The perioperative surgical indicators of patients were recorded,including the surgical time,hospital stay and surgical success rate.The stone removal status was assessed during the 4-week follow-up,and the intraoperative and postoperative complications were recorded.Results As to the 245 patients,the surgical success rate was 98.4%(241/245).Four cases of ureteral stricture were successfully treated with elective lithotripsy after catheterization.One case of damage to a disposable electronic soft mirror occurred during the surgery,but the replacement of a reusable soft mirror was successful.The average surgery time was(42.9±11.5)minutes,and the average postoperative hospital stay(4.05±1.1)days.The stone clearance rate was 97.9%(236/241)4 weeks after the surgery.All the patients experienced mild hematuria after the surgery,and 14 cases developed low-grade fever(<38.5℃).One patient suffered high fever(39.7℃).No serious complication(including ureteral injury and septic shock)occurred to any patient.Conclusions Disposable flexible ureteroscope is safe and effective in treating lower calyceal calculi and is hence worthy of clinical application.