输尿管镜气压弹道联合拦截网篮治疗输尿管结石的疗效分析

目的:回顾性分析输尿管镜气压弹道联合拦截网篮碎石在基层医院治疗输尿管结石的应用。方法:收集2015年3月至2018年12月输尿管镜碎石手术患者病历资料,将190例患者分为2组。A组:单行输尿管硬镜气压弹道碎石组85例,其中中、上段结石50例,下段结石35例;B组:拦截网篮联合输尿管硬镜气压弹道碎石组105例,其中中、上段结石65例,下段结石40例。比较2组患者的碎石成功率、手术时间、术后并发症发生率、住院时间和住院费用,并进一步比较2组中、上段及下段结石的碎石成功率。结果:A组碎石成功率为77.65%(66/85),B组碎石成功率达93.33%(98/105),差异有统计学意义(P<0.05),2组术后并发症、住院时间差异无统计学意义,但B组的住院费用高于A组。A组中、上段结石一次性碎石成功率低于B组,差异有统计学意义(P<0.05);A、B 2组下段结石的成功率差异无统计学意义。结论:采用输尿管硬镜联合拦截网篮可显著提高气压弹道碎石术的成功率。

Application experience of ureteroscopy pneumatic ballistic combined with NTrap in treatment of ureteral stones in a primary hospital

Objective: To review the application experience of ureteroscopy pneumatic lithotripsy combined with NTrap in the treatment of ureteral stones in primary hospitals. Methods: 190 patients who underwent ureteroscopic pneumatic lithotripsy from March 2015 to January 2018 were analyzed. Among these patients, 85 patients who underwent ureteroscopic pneumatic lithotripsy were assigned to group A, 35 cases of lower ureteral stones and 50 cases of middle and upper ureteral stones; 105 patients who underwent ureteroscopic pneumatic lithotripsy combined with the NTrap were assigned to group B, 40 cases of lower ureteral stones and 65 cases of middle and upper ureteral stones. The success rate of lithotripsy, operation time, postoperative complications, hospitalization time, and hospitalization cost were compared between the two groups. Results: The success rate of group A was 77.65% (66/85), and the success rate of group B was 93.33% (98/105), and the difference was statistically significant (P<0.05).There was no statistical difference in the length of hospital stay and postoperative complications,but hospitalization costs were higher in group B than group A. The success rate of disposable lithotripsy in group A was lower than that in group B, and the difference was statistically significant(P<0.05). There was no statistically significant difference in the success rate of lower calculi between groups A and B. Conclusions: The success rate of lithotripsy of upper ureteral calculi can be improved by using the combination of interception basket.