日间手术模式下硕通镜联合软式输尿管镜治疗<20 mm肾结石的临床效果分析

目的 评估硕通镜联合软式输尿管镜治疗长径<20 mm肾结石在日间手术模式中的临床效果。方法 选取2019年1月至2020年12月本院就诊的110例单侧结石长径<20 mm的肾结石患者作为研究对象,随机分为日间手术模式组和常规手术模式组,每组各55例。观察两组的术中置鞘成功率、手术时间、住院时间、住院费用、术后并发症发生率、术后1个月结石清除率以及术后3个月患者满意度。结果 两组共5例患者因置鞘失败改行经皮肾镜碎石术。其余患者均顺利完成手术。日间手术模式组与常规手术模式组患者的术中置鞘成功率、手术时间、术后并发症发生率、术后1个月结石清除率比较,差异均无统计学意义（均P>0.05）。与常规手术模式组比较,日间手术模式组患者住院时间更短,总住院费更低,患者对治疗过程满意度更高,差异均有统计学意义（均P<0.05）。结论 日间手术模式下行硕通镜联合软式输尿管镜治疗结石长径<20 mm肾结石可以缩短治疗周期、减轻患者经济压力,不增加手术风险,且提高了患者的满意度,值得在有条件的医院推广。

Clinical effect analysis of day surgery of Shuotong ureteroscope combined with flexible ureteroscope in the treatment of <20 mm renal calculi

Objective  To evaluate the clinical benefit of Shuotong ureteroscope with flexible ureteroscope in the treatment of renal calculus<20 mm in day surgery mode.Methods  From January 2019 to December 2020, 110 patients with unilateral renal calculus<20 mm who were admitted to our hospital were selected as the research objects, and they were randomly divided into day surgery mode group and conventional surgery mode group, 55 cases in each group. The success rate of ureteroscopic sheath implantation, operation time, hospitalization time, hospitalization cost, postoperative complication rate, stone clearance rate in 1 month after operation, and patient satisfaction in 3 months after operation were observed.Results  A total of 5 patients in the two groups were switched to percutaneous nephrolithotomy due to failure of sheath placement. The remaining patients successfully completed the operation. There was no statistical difference in the success rate of ureteroscopic  sheath implantation, operation time, postoperative complication rate, and stone clearance rate of patients in the day surgery mode group and the conventional operation mode group (all P>0.05). Compared with the conventional surgery model group, patients in the day surgery model group had shorter hospital stays, lower total hospital expenses, and higher patient satisfaction with the treatment process. The differences were statistically significant (all P<0.05).Conclusions  The day surgery mode of Shuotong ureteroscope with soft ureteroscope for treatment of<20 mm renal calculi can shorten the treatment cycle, reduce the economic pressure of the patient, and increase the patient's satisfaction. It is worthy of promotion in qualified hospitals.