摘要
目的:比较复杂性输尿管上段结石(CUUC)患者应用输尿管硬镜联合软镜(F-RURS)与输尿管硬镜碎石术(URL)治疗的效果。方法:选取2018年5月—2023年4月太仓市第一人民医院收治的72例CUUC患者作为研究对象,按照手术方式的不同分成F-RURS组(37例)与URL组(35例)。URL组给予URL治疗,F-RURS组给予F-RURS治疗,比较两组患者围手术期指标、结石清除效果、C反应蛋白(CRP)水平、并发症及复发情况。结果:与URL组比较,F-RURS组患者手术时间更长,结石排净时间、住院时间更短,住院费用更高,差异有统计学意义(t=3.548、5.972、3.641、14.662,P<0.05);与URL组比较,F-RURS组患者一次性碎石成功率、结石彻底清除率更高,差异有统计学意义(χ^(2)=5.731、6.156,P<0.05);术后1 d,F-RURS组患者CRP水平较URL组更低,差异有统计学意义(t=2.904,P<0.05);F-RURS组患者并发症发生率低于URL组,差异有统计学意义(χ^(2)=4.964,P<0.05);F-RURS组患者复发率低于URL组,差异有统计学意义(χ^(2)=4.857,P<0.05)。结论:与URL相比,CUUC患者应用F-RURS治疗,虽然手术时间较长,但能够促进术后恢复,提高结石清除效果,减少CRP水平波动,降低并发症发生率及复发率,在患者经济条件允许的前提下可优先选择F-RURS。
Objective:To compare the efficacy of ureteroscopic combined with flexible ureteroscopy(F-RURS)and ureteroscopic lithotripsy(URL)in the treatment of complex upper ureteral calculi(CUUC).Methods:A total of 72 CUUC patients who were admitted in Taicang First People’s Hospital from May 2018 to April 2023 were selected,and divided into F-RURS group(37 cases)and URL group(35 cases)by different surgical methods.The URL group received URL treatment,while the F-RURS group received F-RURS treatment.The perioperative indicators,stone clearance effect,C-reactive protein(CRP)levels,complications,and recurrence rates of the two groups were compared.Results:Compared with URL group,F-RURS group had longer operation time,shorter stone clearance time and hospital stay,and higher hospitalization cost,with statistically significant difference(t=3.548,5.972,3.641,14.662;P<0.05).Compared with URL group,the success rate of one-off lithotripsis and complete stone clearance rate in F-RURS group were higher,and the differences were statistically significant(χ^(2)=5.731,6.156;P<0.05).On the first day after operation,CRP level in F-RURS group was significantly lower than that in URL group(t=2.904,P<0.05).The complication rate of F-RURS group was lower than that of URL group,and the difference was statistically significant(χ^(2)=4.964,P<0.05).The recurrence rate of F-RURS group was lower than that of URL group,and the difference was statistically significant(χ^(2)=4.857,P<0.05).Conclusion:Compared with URL,F-RURS treatment for CUUC patients can promote postoperative recovery,improve stone clearance,reduce CRP level fluctuations,and reduce the incidence of complications and recurrence.F-RURS can be given priority under the allowance of patient’s economic condition.
作者
孙伟
Sun Wei(Department of Urology,Taicang First People’s Hospital,Taicang,Jiangsu,215400,China)
出处
《黑龙江医学》
2024年第21期2605-2607,共3页
Heilongjiang Medical Journal
