输尿管镜联合超声碎石清石系统与输尿管镜联合气压弹道碎石术治疗复杂输尿管结石的比较

发布时间：2018-01-02 00:28

本文关键词：输尿管镜联合超声碎石清石系统与输尿管镜联合气压弹道碎石术治疗复杂输尿管结石的比较　出处：《中国微创外科杂志》2015年11期 　论文类型：期刊论文

【摘要】：目的探讨输尿管镜联合超声碎石清石系统(EMS第5代)治疗复杂输尿管结石的临床疗效和安全性。方法回顾性比较我院2007年9月~2014年10月手术治疗63例复杂输尿管结石的临床资料,按手术方式分为2组:30例行输尿管镜联合超声碎石清石系统碎石术为超声碎石组(ultrasonic lithotripsy,UL),33例行输尿管镜联合气压弹道碎石术为气压弹道碎石组(pneumatic lithotripsy,PL)。比较2组手术成功率、手术时间、结石完全排出时间,并记录不良事件发生情况。结果 UL组手术成功率93.3%(28/30),明显高于PL组72.7%(24/33)(χ2=4.630,P=0.031)。UL组手术时间(35.9±8.6)min,明显少于PL组(47.9±6.7)min(t=-6.208,P=0.000)。UL组术后结石完全排出时间(16.7±6.7)d,明显短于PL组(27.0±6.9)d(t=-5.999,P=0.000)。2组术后并发症发生率分别为3.3%(1/30)和12.1%(4/33),无统计学差异(χ2=0.676,P=0.411)。随访57例,时间1~85个月,中位随访时间39个月,无输尿管狭窄等远期并发症发生。结论输尿管镜联合超声碎石清石系统治疗复杂输尿管结石安全、有效,具有碎石效率高,手术时间短的优点。
[Abstract]:Objective to investigate the ureteroscopy combined with ultrasonic lithotripsy system (EMS fifth) the clinical efficacy and safety of the treatment of complicated ureteral calculi. Methods Retrospective comparison of our hospital in September 2007 ~2014 year in October 63 cases of surgical treatment of complicated ureteral calculi, according to the type of surgery were divided into 2 groups: 30 patients underwent ureteroscopy combined with ultrasound lithotripsy system for ultrasonic lithotripsy lithotripsy group (ultrasonic lithotripsy, UL), 33 cases underwent ureteroscopy combined with pneumatic lithotripsy for pneumatic lithotripsy group (pneumatic lithotripsy, PL). The 2 groups were compared in operation success rate, operation time, stone expulsion time, and record the occurrence of adverse events. Results the success rate of operation was 93.3% (UL 28/30), was significantly higher than that of PL group 72.7% (24/33) (2=4.630, P=0.031).UL group operation time (35.9 + 8.6) min, significantly less than the PL group (47.9 + 6.7) min (t=, -6.208, P=0.000).UL group after complete stone Discharge time (16.7 + 6.7) d, significantly shorter than that in group PL (27 + 6.9) d (t=-5.999, P=0.000).2 group the incidence of postoperative complications was 3.3% (1/30) and 12.1% (4/33), no significant difference (2=0.676, P=0.411). 57 cases were followed up for 1~85 months, in the median follow-up time of 39 months, no ureteral stenosis and other complications. Conclusion ureteroscopy combined with ultrasonic lithotripsy system for the treatment of complicated ureteral calculi is effective, safe, with gravel and high efficiency, the advantages of shorter operation time.

【作者单位】：解放军第11医院外二科;
【分类号】：R699.4
【正文快照】： 目前,对于体积较大、停留时间较长且周围有息肉形成的复杂输尿管结石行腔内手术有一定困难,最佳治疗方法目前仍有争议。输尿管镜气压弹道碎石术治疗普通中下段输尿管结石有良好效果,但对较大体积结石和停留时间长的结石疗效欠佳。EMS第5代超声碎石清石系统集气压弹道碎石、超

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