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中华腔镜泌尿外科杂志(电子版) ›› 2024, Vol. 18 ›› Issue (05) : 497 -502. doi: 10.3877/cma.j.issn.1674-3253.2024.05.013

临床研究

智能控压输尿管软镜碎石吸引取石术在直径10~25 mm上尿路结石中的应用
莫淇舟1, 苏劲1, 黄健1, 李健维1, 李思宁1, 柳建军1,()   
  1. 1. 524001 湛江,广东医科大学附属医院泌尿外科
  • 收稿日期:2023-12-07 出版日期:2024-10-01
  • 通信作者: 柳建军
  • 基金资助:
    国家自然科学基金项目(81272833); 湛江市科技发展专项资金竞争性分配项目(2021A05075)

Application of intelligent pressure-controlled flexible ureteroscopic suctioning lithotripsy in upper urinary tract stones with diameter of 10-25 mm

Qizhou Mo1, Jin Su1, Jian Huang1, Jianwei Li1, Sining Li1, Jianjun Liu1,()   

  1. 1. Department of Urology, Affiliated Hospital of Guangdong Medical University, Zhanjiang 524001, China
  • Received:2023-12-07 Published:2024-10-01
  • Corresponding author: Jianjun Liu
引用本文:

莫淇舟, 苏劲, 黄健, 李健维, 李思宁, 柳建军. 智能控压输尿管软镜碎石吸引取石术在直径10~25 mm上尿路结石中的应用[J/OL]. 中华腔镜泌尿外科杂志(电子版), 2024, 18(05): 497-502.

Qizhou Mo, Jin Su, Jian Huang, Jianwei Li, Sining Li, Jianjun Liu. Application of intelligent pressure-controlled flexible ureteroscopic suctioning lithotripsy in upper urinary tract stones with diameter of 10-25 mm[J/OL]. Chinese Journal of Endourology(Electronic Edition), 2024, 18(05): 497-502.

目的

比较智能控压输尿管软镜碎石吸引取石术(IPFUSL)与常规输尿管软镜碎石术(RIRS)治疗直径10~25 mm上尿路结石的安全性与有效性。

方法

记录2021年6月至2022年8月于广东医科大学附属医院泌尿外科接受手术治疗并完成术后随访的85例上尿路结石患者的临床资料,根据患者是否接受IPFUSL进行分组,43例患者接受IPFUSL治疗,作为观察组,另外42例患者接受常规RIRS治疗,作为对照组。比较两组手术前后实验室指标,手术时间,术后1个月结石清除率,术后住院时间和并发症发生率等。

结果

85例患者均顺利完成手术,两组患者术前基线资料、术后血白细胞上升值、血红蛋白下降值、肌酐变化值和术后PCT水平的差异无统计学意义(P>0.05)。两组术后1个月结石清除率差异无统计学意义(83.7% vs 73.8%,P>0.05)。观察组术后住院时间短于对照组[(1.2±0.4)d vs (1.5±0.8) d,P=0.045]。观察组并发症总发生率明显低于对照组[4.7% vs 21.4%,P= 0.021]。

结论

IPFUSL与RIRS均是治疗直径10~25 mm上尿路结石有效安全的手术方式,两者的结石清除率相当,但前者的安全性更好,且有术后恢复快、住院时间短的优势,值得临床推广。

Objective

To compare the safety and efficacy of intelligent pressure-controlled flexible ureteroscopic suctioning lithotripsy (IPFUSL) with retrograde intrarenal surgery (RIRS) in the treatment of upper urinary tract stones with diameter of 10 to 25 mm.

Methods

The clinical data of 85 patients with upper urinary tract stones who underwent surgical treatment and completed post-operative follow-up at the Department of Urology, Guangdong Medical University Hospital from June 2021 to August 2022 were recorded. Patients were grouped according to whether they received IPFUSL, 43 patients received IPFUSL as the observation group and 42 patients received conventional RIRS as the control group. Comparison of laboratory indicators before and after surgery, time of surgery, stone removal rate at 1 month after surgery, post-operative hospital stay and complication rate.

Results

All 85 patients successfully completed the operation. There was no statistical significance in preoperative baseline data, postoperative leukocyte rise, hemoglobin decline, creatinine change values and postoperative procalcitonin levels between the two groups (P>0.05). There was no significant difference in stone free rate 1 month after operation between two groups (83.7% vs 73.8%, P>0.05). The postoperative hospitalization stay in the observation group was shorter than the control group [(1.2±0.4) d vs (1.5±0.8) d, P=0.045]. The incidence of surgical complications in the observation group was significantly lower than the control group [4.7% vs 21.4%, P=0.021].

Conclusions

IPFUSL and RIRS are both safe and effective surgical methods for the treatment of upper urinary stones with diameters of 10 to 25 mm. The stone free rate of them is similar, but the former has better safety, and has the advantages of quick postoperative recovery and short hospital stay, which is worthy of promotion in clinical practice.

图1 智能控压输尿管软镜碎石吸引取石术术中健侧斜仰卧位  图2 输尿管测压吸引鞘  图3 医用智能灌注吸引平台
表1 两组上尿路结石患者术前资料比较
表2 两组上尿路结石患者术中和术后资料比较
表3 两组上尿路结石患者术中和术后并发症对比[例(%)]
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