目的 探讨输尿管镜下气压弹道碎石术(URSL)治疗输尿管中下段结石并发感染患者的临床效果。方法 选择2017年1月—2020年7月间收治的输尿管中下段结石患者,选取其中60例合并感染症状的患者为研究对象,参照随机分层法将患者分为对照组(n=30)和研究组(n=30),给予对照组体外冲击波碎石术(ESWL)治疗,给予研究组URSL治疗,比较两组治疗效果。结果 研究组一次性结石清除成功率(90%)明显高于对照组(76.67%),并发症发生率(6.67%)明显低于对照组(26.67%),差异显著(P<0.05)。对照组和研究组治疗前降钙素原、尿白细胞计数(LEU)、超敏C反应蛋白(hs-CRP)、肌酐和血常规白细胞计数的水平间无明显差异(P>0.05),治疗后研究组上述5项指标的水平明显低于对照组,差异显著(P<0.05)。结论 对输尿管中下段结石患者使用URSL治疗,其效果远胜于ESWL治疗,临床应用价值显著。
Objective To investigate the clinical effect of ureteroscopic lithotripsy using Swiss Lithoclast (URSL) on middle and lower ureteral calculi complicated with infection. Methods Sixty middle and lower ureteral calculi patients with infection treated from January 2017 to July 2020 were selected and divided into a control group (n=30) and a study group (n=30) by random stratification method. The control group was treated with extracorporeal shock wave lithotripsy (ESWL); the study group was treated with URSL. Surgical effects were probed. Results The one-time removal rate in the study group (90%) was higher than that in the control group (76.67%). The complication rate in the study group (6.67%) was lower than that in the control group (26.67%, P<0.05). Before surgery, the levels of procalcitonin, leukocyte (LEU), hypersensitive C-reactive protein (hs-CRP), creatinine, and white blood cell count between the two groups were not significantly different (P>0.05): After surgery, the five indicators in the study group were significantly lower than those in the control group (P<0.05). Conclusion URSL has better effects than ESWL for middle and lower ureteral calculi patients.
[1] 郝宗耀,曾国华,刘明,等.输尿管软镜与微通道经皮肾镜碎石术治疗输尿管上段结石的对照分析[J].外科研究与新技术,2017,6(4):246-249.
[2] 王春球,李玉勤,孟献国,等.体外冲击波碎石联合输尿管镜治疗输尿管上段较大结石的疗效观察[J].外科研究与新技术,2019,8(3):180-182.
[3] 黄初阳,龙永福.体外物理振动排石治疗输尿管中下段小结石的临床研究[J].国际泌尿系统杂志,2020,40(2):203-206.
[4] 宋思吉,李前伟,吴小军,等.经皮肾镜联合输尿管软镜治疗尿流改道术后输尿管中下段结石的疗效分析[J].中国医学前沿杂志(电子版),2020,12(2):40-43.
[5] 杨林,史玉强,雷振涛,等.Peel-away塑料薄膜鞘结合输尿管镜气压弹道碎石术治疗女性输尿管中下段复杂性结石的临床应用价值[J].微创泌尿外科杂志,2019,8(5):319-323.
[6] 思建民. 经尿道输尿管镜气压弹道碎石术治疗中下段输尿管结石的体会[J].临床医药文献电子杂志,2019,6(10):74-75.