通讯作者: 黄勇平, h.y.p.1968@163.com

DOI：10.12201/bmr.202408.00067

Analysis of the Curative Effect of Combined Treatment of Renal or Upper Ureteral Calculi with Double Endoscopy

• 摘要：目的：探讨负压组合式输尿管镜（沃通镜）联合输尿管软镜钬激光碎石治疗最大径线为2～4cm肾或输尿管上段结石的疗效。方法：收集我院2023年3月至2024年3月住院治疗的最大径线为2～4cm的肾或输尿管上段结石患者病例资料，分为观察组和对照组，观察组采用沃通镜联合输尿管软镜钬激光碎石，对照组采用李逊肾镜行经皮肾镜碎石术（percutaneous nephrostolithotomy，PCNL）。比较两组的手术时间、术后住院时间、手术前后血常规白细胞（white blood cell，WBC）变化情况、手术前后尿常规WBC变化情况、术后视觉模拟疼痛评分（visual analogue pain score，VAS）分度、一期结石清除率及术后并发症发生情况等指标。结果：观察组术后视觉模拟疼痛评分（VAS）分度及术后住院时间显著低于对照组（p＜0.05）；两组的手术时间、一期结石清石率、术后血常规WBC、术后尿常规WBC差异无统计学意义（p＞0.05）；但两组手术后血常规WBC均较术前增高（p＜0.05）；两组间的结石清石率差异无统计学意义（p＞0.05）。结论：沃通镜联合输尿管软镜钬激光碎石治疗最大径线为2～4cm肾或输尿管上段结石安全有效，有望部分替代PCNL，成为治疗最大径线为2～4cm肾或输尿管上段结石的另一种安全及可靠的术式。

  关键词： 负压组合式输尿管镜; 输尿管软镜; 肾和输尿管上段结石; 钬激光碎石

   

  Abstract: Objective: To investigate the efficacy of negative pressure combined ureteroscopy ( Wo Tong mirror ) combined with flexible ureteroscopy holmium laser lithotripsy in the treatment of renal or upper ureteral calculi with a maximum diameter of 2 ~ 4cm. Methods: The data of patients with renal or upper ureteral calculi with a maximum diameter of 2 ~ 4cm who were hospitalized in our hospital from March 2023 to March 2024 were collected and divided into observation group and control group. The observation group was treated with negative pressure combined ureteroscopy ( Wo Tong Mirror ) combined with flexible ureteroscopy for holmium laser lithotripsy, and the control group was treated with Lisson nephroscope for percutaneous nephrolithotomy (PCNL). The operation time, postoperative hospital stay, changes of blood routine white blood cell (WBC) before and after operation, changes of urine routine WBC before and after operation, postoperative visual analogue pain score (VAS), one-stage stone clearance rate and postoperative complications were compared between the two groups. Results: The postoperative hospitalization time and visual analogue pain score (VAS) of the observation group were significantly lower than those of the control group (p<0.05). There was no significant difference in the operation time, stone clearance rate, postoperative blood routine WBC and postoperative urine routine WBC between the two groups (p>0.05). However, the blood routine WBC of the two groups after operation was higher than that before operation (p<0.05).The overall stone clearance rate of the two surgical methods was 86.25 %, of which the stone clearance rate of the observation group was 82.5 %, and the control group was 90 %. There was no significant difference between the two groups (p>0.05).Conclusion: It is safe and effective to treat renal or upper ureteral calculi with a maximum diameter of 2 ~ 4cm by Wharton s mirror combined with flexible ureteroscope holmium laser lithotripsy. It is expected to partially replace PCNL and become another safe and reliable operation for the treatment of renal or upper ureteral calculi with a maximum diameter of 2 ~ 4cm.

  Key words: Negative pressure combined ureteroscope; Flexible ureteroscope; renal and upper ureteral calculi; Holmium laser lithotripsy

  提交时间：2024-08-27

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• 序号	提交日期	编号	操作
  1	2024-07-24	bmr.202408.00067V1	下载

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