组合式输尿管软镜与电子输尿管软镜行碎石手术的比较研究

Comparison of modular flexible ureteroscopy and electronic flexible ureteroscopy for treating upper urinary calculi.

目的:比较组合式输尿管软镜与电子输尿管软镜在行碎石手术时的碎石效率及安全性。方法:收集2014年6月~2015年6月行输尿管软镜钬激光碎石的病例共94例,分为电子输尿管软镜组35例和组合式输尿管软镜组59例,比较两组在手术时间、成功率、并发症、残石率等方面的差异。结果:电子输尿管软镜组手术成功率为100%,组合式输尿管软镜组手术成功率为84.7%;术后电子输尿管软镜组有6例出现尿脓毒血症,而组合式输尿管镜组仅有1例出现尿脓毒血症,治疗后均好转,均差异有统计学意义(P<0.05)。两组的手术时间分别为平均为(32.6±7.3)min、(39.2±6.8)min;电子输尿管软镜组有2例结石残留,ESWL治疗后排空,组合式输尿管软镜术后有2例发生石街、2例结石残留,ESWL治疗后均排空,均差异无统计学意义(P>0.05)。结论:组合式输尿管软镜与电子输尿管软镜行碎石手术都是安全有效的手术方式。电子输尿管软镜由于清晰度高操作灵活,手术成功率高于组合式输尿管软镜,但经过训练后组合式输尿管软镜也能达到较好的碎石效果,而且由于组合式软镜的镜体更细,并发症的发生率更低。

Objective:To compare the the efficiency and security of modular flexible ureteroscopy and electronic flexible ureteroscopy for treating upper urinary calculi.Methods:From June 2014 to June 2015,94 patients with upper urinary calculi were treated by modular flexible ureteroscopy(35cases,group A)or electronic flexible ureteroscopy(59cases,group B).Procedural time,success rate of surgery,complication rate and the residual stone rate were compared.Results:In groups A and B,success rate of surgery was 100% and 84.7%(P<0.05),the cases of sepsis were 6and 1(P<0.05),procedural time was(32.6±7.3)min and(39.2±6.8)min(P <0.05),and the cases of residual stone were 2and 4,respectively.Conclusions:Both modular flexible ureteroscopy and electronic flexible ureteroscopy are effective and safe therapeutic modalities.Electronic flexible ureteroscopy is better than modular flexible ureteroscopy in success rate of surgery because of its high definition and flexible operation.But after the training,modular flexible ureteroscopy also has good operation effect.And because of its thinner lens body,the complication rate of modular flexible ureteroscopy is lower.