输尿管扩张鞘在输尿管软镜治疗1～2cm肾结石中的应用价值

发布时间：2018-05-09 17:13

  本文选题：肾结石 + 输尿管软镜　； 参考：《华中科技大学学报(医学版)》2017年06期

【摘要】：目的探讨输尿管扩张鞘(ureteral access sheath,UAS)在输尿管软镜(flexible ureteroscopy,fURS)治疗1~2cm肾结石中的应用价值。方法回顾性分析2015年9月~2017年9月在苏州大学附属第一医院行fURS手术治疗的190例1~2cm肾结石患者的临床资料。UAS(大小F14/12)组133例,年龄22~76岁,平均(52±12)岁,男85例,女48例;结石长径平均(1.6±0.2)cm;肾盂、中盏及上盏结石共90例,下盏结石28例,多发结石15例。未使用UAS组57例,年龄16~83岁,平均(50±15)岁,男35例,女22例;结石长径平均(1.5±0.1)cm;肾盂、中盏及上盏结石共38例,下盏结石12例,多发结石7例。对2组患者手术时间、手术并发症和一期结石清除率进行比较分析。结果 2组在年龄、性别比例、结石大小和结石分布上差异均无统计学意义。2组手术时间分别为(80±25)min和(75±19)min(P0.05);术中输尿管损伤发生率分别为6.0%(8/133)和3.5%(2/57)(P0.05);术后发热发生率分别为9.8%(13/133)和21.1%(12/57)(P=0.035);术后4周随访结石清除率分别为81.2%(108/133)和75.4%(43/57)(P0.05)。结论对于长径为1~2cm的肾结石,fURS术中使用和不使用UAS的术后结石清除率无明显差异,使用UAS不会增加输尿管损伤的发生率,但是术后发热的发生率明显下降。
[Abstract]:Objective to investigate the value of ureteral access sheath (UAS) in the treatment of 1~2cm renal calculi with flexible ureteroscopy (fURS) in the treatment of 1~2cm renal calculi. Methods a retrospective analysis of the clinical data of 190 cases of 1~2cm renal calculi in September September 2015 ~2017 in First Hospital Affiliated to Suzhou University. 2) group 133 cases, age 22~76 years, average age (52 + 12) years, male 85 cases, 48 cases, average stone length (1.6 + 0.2) cm, renal pelvis, calyx and upper calculi in 90 cases, 28 cases of lower calyx stone, 15 cases of multiple stones. The average age of 52 years old, average age (50 +) years, male and female, cm; renal pelvis, calycalycad and upper calculi A total of 38 cases, 12 cases of lower calyx stones and 7 cases of multiple stones. The operation time, surgical complications and one stage stone clearance rate in the 2 groups were compared and analyzed. Results there was no significant difference between the 2 groups in age, sex ratio, stone size and stone distribution in group.2 (80 + 25) min and (75 + 19) min (P0.05), and ureteral injury during the operation. The incidence was 6% (8/133) and 3.5% (2/57) (P0.05) respectively. The incidence of postoperative fever was 9.8% (13/133) and 21.1% (12/57) (P=0.035), respectively. The stone clearance rates were 81.2% (108/133) and 75.4% (P0.05) at 4 weeks after operation. Conclusion there was no obvious stone clearance rate in fURS and without UAS. Differences in the use of UAS did not increase the incidence of ureteral injury, but the incidence of postoperative fever decreased significantly.

【作者单位】： 苏州大学附属第一医院泌尿外科;
【分类号】：R699.2
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本文编号：1866860