一次性输尿管软镜在具有内镜损害高危因素上尿路结石手术中的初步应用

目的比较一次性与重复性输尿管软镜处理具有内镜损害高危因素上尿路结石的疗效。 方法回顾性分析2019年6月至2020年9月于我院输尿管软镜治疗的具有内镜损害高危因素（RUSS结石评分≥3分）患者的临床资料，其中一次性软镜组29例，重复性软镜组35例，比较两组年龄、BMI、RUSS评分、手术时间、住院天数、并发症及清石率等临床资料。 结果两组年龄、BMI、RUSS评分、术后住院天数、Clavien Ⅰ~Ⅱ级并发症等差异无统计学意义（P>0.05）。一次性软镜组与重复性软镜组手术时间为（105±10）min和（90±6）min术后１个月清石率为75.86%（22/29）和51.43%（18/35），两组比较差异有统计学意义（P<0.05）。 结论对于主动选择输尿管软镜治疗的具有内镜损害高危因素的上尿路结石患者，推荐其使用一次性软镜手术，可提高手术效果并节约医院经济成本，有利于医疗资源的合理配置。

Initial experiences of disposable digital flexible ureteroscope in the treatment of upper urinary calculi with high risk factors of endoscopic injury

ObjectiveTo compare the therapeutic effect between disposable digital flexible ureteroscope with reusable ureteroscope in treating of upper urinary calculi with high risk factors of endoscopic injury. MethodsThe clinical data of patients with upper urinary calculi whose RUSS score ≥3 treated by either disposable digital flexible ureteroscope (n=29) or reusable ureteroscope (n=35) in our hospital from June 2019 to September 2020 were analyzed retrospectively. The age, BMI, RUSS score, operation time, postoperative hospital stay, complications and stone-free rate were compared between the two groups. ResultsThere was no significant differentce of the mean age, BMI, RUSS score, postoperative hospital stay and Clavien I-II complications rates of the two group between two groups (P>0.05). The operation time and the stone-free rate after 1 month of the disposable digital flexible ureteroscope group and reusable ureteroscope group were (105±10) min and (90±6) min, 75.86%(22/29) and 51.43%(18/35), the differences were statistical significant (P<0.05). ConclusionFor those patients of upper urinary tract calculi with high risk of endoscopy damage, disposable flexible ureteroscope operation is highly recommended as the response to their recourse to flexible ureteroscope, which can not only improve the surgical effect but also save the economical costs of hospital, hence conduct the reasonable allocation of medical resources.