本文選題：腎結(jié)石 + 輸尿管軟鏡�。� 參考：《華中科技大學(xué)學(xué)報(bào)(醫(yī)學(xué)版)》2017年06期

【摘要】：目的探討輸尿管擴(kuò)張鞘(ureteral access sheath,UAS)在輸尿管軟鏡(flexible ureteroscopy,fURS)治療1~2cm腎結(jié)石中的應(yīng)用價(jià)值。方法回顧性分析2015年9月~2017年9月在蘇州大學(xué)附屬第一醫(yī)院行fURS手術(shù)治療的190例1~2cm腎結(jié)石患者的臨床資料。UAS(大小F14/12)組133例,年齡22~76歲,平均(52±12)歲,男85例,女48例;結(jié)石長(zhǎng)徑平均(1.6±0.2)cm;腎盂、中盞及上盞結(jié)石共90例,下盞結(jié)石28例,多發(fā)結(jié)石15例。未使用UAS組57例,年齡16~83歲,平均(50±15)歲,男35例,女22例;結(jié)石長(zhǎng)徑平均(1.5±0.1)cm;腎盂、中盞及上盞結(jié)石共38例,下盞結(jié)石12例,多發(fā)結(jié)石7例。對(duì)2組患者手術(shù)時(shí)間、手術(shù)并發(fā)癥和一期結(jié)石清除率進(jìn)行比較分析。結(jié)果 2組在年齡、性別比例、結(jié)石大小和結(jié)石分布上差異均無(wú)統(tǒng)計(jì)學(xué)意義。2組手術(shù)時(shí)間分別為(80±25)min和(75±19)min(P0.05);術(shù)中輸尿管損傷發(fā)生率分別為6.0%(8/133)和3.5%(2/57)(P0.05);術(shù)后發(fā)熱發(fā)生率分別為9.8%(13/133)和21.1%(12/57)(P=0.035);術(shù)后4周隨訪結(jié)石清除率分別為81.2%(108/133)和75.4%(43/57)(P0.05)。結(jié)論對(duì)于長(zhǎng)徑為1~2cm的腎結(jié)石,fURS術(shù)中使用和不使用UAS的術(shù)后結(jié)石清除率無(wú)明顯差異,使用UAS不會(huì)增加輸尿管損傷的發(fā)生率,但是術(shù)后發(fā)熱的發(fā)生率明顯下降。
[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.

【作者單位】： 蘇州大學(xué)附屬第一醫(yī)院泌尿外科;
【分類號(hào)】：R699.2
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本文編號(hào)：1866860