一期经输尿管硬通道下软硬镜与软通道下软镜钬激光碎石治疗直径2~4cm肾盂结石的比较

发布时间：2018-01-05 07:12

本文关键词：一期经输尿管硬通道下软硬镜与软通道下软镜钬激光碎石治疗直径2~4cm肾盂结石的比较　出处：《中国微创外科杂志》2016年02期 　论文类型：期刊论文

【摘要】：目的比较经输尿管硬通道下软硬镜与经输尿管软通道下软镜钬激光碎石术治疗直径2~4 cm肾盂结石的有效性及安全性。方法回顾性分析2012年2月~2014年7月直径2~4 cm肾盂结石的临床资料,其中经输尿管硬通道下软硬镜钬激光碎石术67例,经输尿管软通道下软镜钬激光碎石术52例,比较2组一期通道建立成功率、手术时间、术后住院时间、结石清除率及并发症。结果硬通道组和软通道组的一期通道建立成功率分别为80.6%(54/67)和76.9%(40/52)(χ2=0.238,P=0.626),手术时间分别为(39.1±8.2)min和(43.5±6.4)min(t=-2.832,P=0.006),术后住院时间分别为(2.1±0.4)d和(2.0±0.5)d(t=1.288,P=0.201),术后1天结石清除率分别为83.3%(45/54)和55.0%(22/40)(χ2=9.010,P=0.003),术后4周结石清除率分别为96.3%(52/54)和70.0%(28/40)(χ2=12.536,P=0.000),并发症发生率分别为11.1%(6/54)和12.5%(5/40)(χ2=0.000,P=1.000)。结论一期经输尿管硬通道下软硬镜联合钬激光碎石术治疗直径2~4 cm的肾盂结石安全性好,疗效确定,手术时间短,结石清除率高,比经输尿管软通道下软镜钬激光碎石术具有更大的优势。
[Abstract]:Objective to compare the efficacy and safety of ureteral hard mirror and soft channel soft soft channel via ureteroscope holmium laser lithotripsy in the treatment of 2~4 in diameter cm of the renal calculus. Methods Retrospective analysis of clinical data in February 2012 July ~2014 2~4 cm the diameter of the renal calculus, the ureter channel combination of endoscopic holmium laser lithotripsy in 67 cases. The soft channel soft ureteral holmium laser lithotripsy in 52 cases, compared 2 groups of a channel establishment success rate, operation time, postoperative hospital stay, stone clearance rate and complications. Results of hard and soft channel channel group group a channel establishment success rate were 80.6% (54/67) and 76.9% (40/52) (x 2=0.238, P=0.626), the operation time was (39.1 + 8.2) min and (43.5 + 6.4) min (t=-2.832, P=0.006), postoperative hospitalization time was (2.1 + 0.4) D and (2 + 0.5) d (t=1.288, P=0.201), after 1 days of stone clearance rate was 83.3% (45/54) and 55% (22/40) (2=9.010, P=0.003), 4 weeks after the operation, stone clearance rate was 96.3% (52/54) and 70% (28/40) (2=12.536, P=0.000), the complication rate was 11.1% (6/54) and 12.5% (5/40) (2=0.000, P=1.000). A conclusion the safety of ureteral calculi under hard channel combination of endoscopic holmium laser lithotripsy for treatment of 2~4 diameter cm, determined curative effect, short operation time, high stone clearance rate, has more advantages than the soft channel soft ureteral holmium laser lithotripsy.

【作者单位】：广东省江门市五邑中医院泌尿外科;
【分类号】：R699.2
【正文快照】： 软性输尿管肾镜治疗直径2 cm以下肾结石的优势已得到公认[1],其结石清除率与经皮肾镜技术相同[2,3],但手术风险更小,因此更具有优势。随着软镜技术的提高,治疗的肾结石直径亦超过2 cm,但由于软镜术中无法有效清除碎石,因此治疗直径2 cm以上的肾结石,往往需要分期手术[4]。我院

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