摘要
目的探讨逆行肾内输尿管软镜碎石术(RIRS)联合排石用输尿管支架治疗>2 cm肾或输尿管上段结石的效果。方法回顾性分析2021年6月至2022年6月在福建医科大学附属闽东医院被诊断为肾或输尿管上段结石的70例患者的临床资料,所有患者结石直径均>2 cm,并行RIRS,术后根据使用支架管的种类分为试验组和对照组。试验组应用排石用输尿管支架管,共30例;对照组应用普通双J管,共40例。收集两组患者的手术时间、术后当天血白细胞计数,尿白细胞计数,术后4周返院拔管时填写输尿管相关症状问卷,比较两组留置输尿管支架期间是否排尿时有碎石排出及术后并发症情况。结果两组性别、年龄、结石位置、结石大小、结石CT值、术前血白细胞、术前尿白细胞比较,差异均无统计学意义(P>0.05)。两组手术时间、术后血白细胞、术后尿白细胞、术后排尿症状评分、躯体疼痛评分、整体健康状况评分和工作表现评分比较,差异均无统计学意义(P>0.05)。试验组在带管期间的促排石能力高于对照组,差异有统计学意义(P<0.05)。试验组在术后4周的残石率低于对照组,差异有统计学意义(P<0.05)。但两组在感染发热、石街形成、支架移位、结石附壁、腰痛和血尿方面比较,差异无统计学意义(P>0.05)。结论RIRS联合排石用输尿管支架治疗>2 cm肾或输尿管上段结石可以提高患者的促排石能力,降低残石率,不增加不良反应。
Objective To investigate the efficacy of retrograde intrarenal surgery(RIRS)combined with stone drainage ureteral stent in the treatment of renal or upper ureteral calculi larger than 2 cm in diameter.Methods The datas of 70 patients with renal or upper ureteral calculi larger than 2 cm in diameter diagnosed in Mindong Hospital Affiliated to Fujian Medical University from June 2021 to June 2022 were analyzed retrospectively.All patients were treated by RIRS.And the patients were divided into a experimental group and a control group based on the type of ureteral stent used after surgery.There were 30 patients in experimental group who were placed in stone drainage ureteral stent and there were 40 patients in control group who were placed in traditional double J stent.The operation time,blood white blood cell count and urine white blood cell count of the two groups were collected,and the ureteral-related symptoms questionnaire was filled in when the two groups returned to the hospital for extubation 4 weeks after the operation.The situation of lithotriptic discharge and postoperative complications during urination during ureteral stent indwelling was compared between the two groups Results There were no statistically significant differences between the experimental group and the control group in terms of gender,age,stone location,stone size,stone CT value,preoperative blood leukocytes and urine leukocytes(P>0.05).There were no statistically significant differences between the two groups in terms of operation time,postoperative blood leukocytes,postoperative urine leukocytes,voiding symptoms scores,physical pain symptoms scores,general health status scores and work ability impact scores(P>0.05).The patients'ability of promoted stone excretion in the experimental group was stronger than that in the control group,with statistically significant difference(P<0.05).4 weeks after surgery,the residual stone rate in the experimental group was lower than that in the control group,with statistically significant difference(P<0.05).However,there were no statistically significant differences between the two groups in terms of infection fever,stone street formation,migrationt,encrustation,flank pain and hematuria(P>0.05).Conclusion The combination of RIRS and stone drainage ureteral stent in treatment of>2 cm renal or upper ureteral calculi could improve patients'ability to expel stones,reduce the residual stone rates,and do not increase adverse reactions.
作者
尧义
李惠长
李国敏
YAO Yi;LI Huizhang;LI Guomin(Department of Urology,Mindong Hospital Affiliated to Fujian Medical University,Fujian Province,Fu'an355000,China)
出处
《中国当代医药》
CAS
2024年第5期77-81,共5页
China Modern Medicine
基金
福建省自然科学基金资助项目(2023J011902)
福建中医药大学校管课题(XB2023190)。
