远端可弯输尿管导引鞘联合软性输尿管镜治疗感染性上尿路结石的应用效果分析

A retrospective analysis of the efficacy of distal flexible ureteral guide sheath combined with flexible ureteroscope in the treatment of infectious upper urinary calculi

目的:分析远端可弯输尿管导引鞘联合软性输尿管镜治疗感染性上尿路结石的安全性及有效性。方法:回顾性分析2019年10月至2023年1月赣南医科大学第一附属医院及寻乌县人民医院泌尿外科86例行输尿管导引鞘联合经尿道软性输尿管镜碎石取石术患者的临床资料,根据使用输尿管导引鞘的差异分为研究组(45例)及对照组(41例),研究组采用远端可弯输尿管导引鞘,对照组采用常规输尿管导引鞘,比较2组患者术后并发症发生率、清石率的差异。结果:研究组术后1 d清石率为80.0%,对照组术后1 d清石率为51.2%,2组间差异有统计学意义(P<0.05);术后30 d清石率研究组为86.7%,对照组为78.0%,2组比较差异无统计学意义(P>0.05)。研究组4例继发发热(腋温>38.0℃),对照组11例,2组比较差异有统计学意义(P<0.05)。研究组并发症发生率为20.0%,对照组为46.3%,2组比较差异有统计学意义(P<0.05)。结论:远端可弯输尿管导引鞘联合软性输尿管镜治疗感染性上尿路结石具有良好的安全性和有效性,有较好的临床应用价值。

Objective:To evaluate the safety and efficacy of distal flexible ureteral guide sheath combined with flexible ureteroscope in the treatment of infectious upper urinary calculi.Methods:Clinical data of 86 patients undergoing distal flexible ureteral guide sheath combined with flexible ureteroscope in the Department of Urology of The First Affiliated Hospital of Gannan Medical University and Xunwu People's Hospital from October 2019 to January 2023 were analyzed retrospectively.According to the difference of ureteral access sheath,the patients were divided into study group(46 cases)and control group(41 cases).The study group used a distal flexible ureteral access sheath,and the control group used a conventional ureteral access sheath.The differences in stone free rate and postoperative complications between the two groups were compared.Results:The stone-free rates 1 day after operation was 80.0%in the study group and 51.2%in the control group,with statistical significance(P<0.05).In addition,the stone-free rates 30 days after surgery was 86.7%in the study group and 78.0%in the control group,with statistical significance(P>0.05).There were 4 patients with fever(armpit temperature>38.0℃)in the study group and 11 in the control group,with statistical significance(P<0.05).The total complication rate was 20.0%in the study group and 46.3%in the control group,with statistical significance(P<0.05).Conclusion:Distal flexible ureteral guide sheath combined with flexible ureteroscope in the treatment of infectious upper urinary calculi is safe and effective.It is worth practising clinically.