摘要
目的探讨输尿管镜钬激光碎石联合N-trap拦截网治疗输尿管上段结石的安全性及有效性。方法回顾性分析2017-03/2019-03月在中部战区总医院就诊并行输尿管镜钬激光碎石术治疗的输尿管上段结石患者88例,根据术中是否使用N-trap拦截网分为N-trap组(n=46)和对照组(n=42)。N-trap组采用输尿管镜钬激光碎石术联合使用N-trap结石拦截网,对照组单纯采用输尿管镜钬激光碎石术,两组患者术后均给予间苯三酚及枸橼酸氢钾钠颗粒辅助治疗。比较两组患者平均手术时间、碎石成功率、结石上移率、结石清除率、手术并发症、术后住院天数。结果 N-trap组手术时间长于对照组,碎石成功率及结石清除率均显著高于对照组,组间比较差异有统计学意义(P<0.05)。N-trap组结石上移率显著低于对照组,组间差异有统计学意义(P<0.05)。两组患者术后住院天数及术后发热率比较均无明显差异(P>0.05)。所有患者均未发生输尿管穿孔、输尿管撕脱、严重的出血、感染性休克等并发症。结论输尿管镜钬激光碎石联合N-trap拦截网治疗输尿管上段结石安全有效,能显著提升患者碎石成功率及结石清除率,减少术后结石残留,且不增加临床并发症及术后住院时间,可作为输尿管上段结石的有效治疗手段。
Objective To explore the safety and efficacy of ureteroscopic holmium laser lithotripsy combined with N-trap in the treatment of upper ureteral calculi.Methods A total of 88 upper ureteral calculi patients who underwent ureterocopic holmium laser lithotripsy in General Hospital of Central Theater Command from March 2017 to March 2019 were retrospectively analyzed.The patients were divided into N-Trap group(n=46)and control group(n=42)according to whether N-trap was used during the operation.Patients in the N-Trap group were treated with ureteroscopic holmium laser lithotripsy combined with N-Trap,while the patients in the control group were treated with ureteroscopic holmium laser lithotripsy only.All patients were treated with phloroglucinol and potassium sodium hydrogen citrate granules after surgery.The operation time,success rate of lithotripsy,stone migration rate,stone clearance rate,surgical complications and postoperative hospital stay were compared between the two groups.Results The operation time of the N-trap group was longer than that of the control group(P<0.05),and the success rate of lithotripsy and stone clearance rate of the N-trap group were significantly higher than those of the control group(P<0.05).The stone migration rate of N-trap group was significantly lower than that of the control group(P<0.05).There were no significant differences in the postoperative hospital stay and postoperative fever rate between the two groups(P>0.05).None of the patients had ureteral perforation,ureteral avulsion,severe bleeding,septic shock or other complications.Conclusion Ureteroscopic holmium laser lithotripsy combined with N-trap in the treatment of upper ureteral calculi is safe and effective,which can significantly improve the success rate of lithotripsy and stone clearance rate of patients,reduce postoperative stone residue,and do not increase clinical complications and postoperative hospital stay.Therefore,it can be used as an effective treatment method for upper ureteral calculi.
作者
彭轶辉
沈国球
潘铁军
夏强
李晋军
PENG Yihui;SHEN Guoqiu;PAN Tiejun;XIA Qiang;LI Jinjun(School of Medicine,Wuhan University of Science and Technology,Wuhan Hubei 430081,China)
出处
《华南国防医学杂志》
CAS
2020年第3期176-179,共4页
Military Medical Journal of South China
