柔性可弯负压清石鞘联合软镜治疗上尿路结石的临床研究

Clinical study of flexible negative pressure lithotripsy sheath combined with flexible endoscopy in the treatment of upper urinary tract calculi

目的分析柔性可弯负压清石鞘联合软镜对上尿路结石患者的影响。方法选取2023年1月至2024年1月宜春市人民医院收治的80例上尿路结石患者作为研究对象,按照随机数字表法分为对照组与观察组,每组各40例。对照组行普通工作鞘联合输尿管软镜手术,观察组行柔性可弯负压清石鞘联合输尿管软镜手术。比较两组的手术相关指标、炎症因子水平、疼痛程度、并发症发生情况。结果观察组手术时间为(47.54±4.75)min,短于对照组的(59.83±6.31)min,结石清除率为95.00%(38/40),高于对照组的77.50%(31/40),术中出血量为(6.34±1.22)ml,少于对照组的(10.71±1.89)ml,并发症总发生率为5.00%(2/40),低于对照组的20.00%(8/40),差异有统计学意义(P<0.05);术后,观察组的白介素-6、C反应蛋白、肿瘤坏死因子-α、降钙素原水平均低于对照组,差异有统计学意义(P<0.05);术后6、24 h,观察组的疼痛程度评分均低于对照组,差异有统计学意义(P<0.05)。结论柔性可弯负压清石鞘联合软镜可减少出血量,缩短手术时间,引起的炎症反应更轻,可缓解上尿路结石患者术后疼痛,且并发症少,临床可推广应用。

Objective To analyze the effect of flexible negative pressure lithotripsy sheath combined with flexible endoscopy on patients with upper urinary tract calculi.Methods A total of 80 patients with upper urinary tract calculi in Yichun People's Hospital from January 2023 to January 2024 were selected as research objects,and they were divided into control group and observation group according to random number table method,with 40 cases in each group.The control group received ordinary working sheath combined with flexible ureteroscopy,while the observation group received flexible negative pressure lithotripsy sheath combined with flexible ureteroscopy.The operation related indicators,inflammatory factor levels,pain degree and complications were compared between the two groups.Results the operation time of the observation group was(47.54±4.75)min,shorter than(59.83±6.31)min of the control group,the stone clearance rate was 95.00%(38/40),higher than 77.50%(31/40)of the control group,the intraoperative blood loss was(6.34±1.22)ml,less than(10.71±1.89)ml of the control group,the total incidence of complications was 5.00%(2/40),lower than 20.00%(8/40)of the control group,with statistically significant differences(P<0.05).After operation,the levels of interleukin-6,C-reactive protein,tumor necrosis factor-αand procalcitonin in the observation group were lower than those in the control group,and the differences were statistically significant(P<0.05).At 6 h and 24 h after operation,the pain degree scores of the observation group were lower than those of the control group,and the differences were statistically significant(P<0.05).Conclusion The flexible negative pressure lithotripsy sheath combined with flexible endoscopy can reduce the amount of bleeding,shorten the operation time,cause less inflammatory reaction,relieve the postoperative pain of patients with upper urinary tract calculi,and have fewer complications,which is worthy of clinical application.