输尿管软镜治疗孤立肾合并上尿路结石的可行性分析

目的探讨输尿管软镜在治疗孤立肾合并上尿路结石中的安全性及疗效。方法回顾性分析2015年10月至2018年9月我科应用FURS治疗的孤立肾与非孤立肾合并上尿路结石各32例,分别为孤立肾组、非孤立肾组,比较两组的手术时间、术后住院天数、结石清除率、并发症等。结果两组均能一次顺利入镜完成手术,在手术时间、术后住院天数、结石清除率以及并发症(发热、出血、肾功能衰竭、石街形成、输尿管狭窄形成)发生率方面差异均无统计学意义(P>0.05),两组术后血尿素氮均较术前显著降低(P<0.05),两组术后肾功能较术前差异均无统计学意义(P>0.05),孤立肾组术后较术前有一过性的血肌酐增高(P<0.05)。结论输尿管软镜治疗孤立肾合并上尿路结石安全、可靠,对肾功能影响小,值得临床医师借鉴应用。

The feasibility of flexible ureteroscopy with holmium laser lithotripsy in treating upper urinary stones in solitary kidneys

Objective To evaluate the safety and efficacy of flexible ureteroscopy with holmium laser lithotripsy in treating upper urinary stones in solitary kidneys.Methods In our hospistal,from October 2015 to September 2018,64 patients with upper urinary stones equally in solitary kidneys or non-solitary kidneys were treated with flexible ureteroscopic lithotripsy,which were classified as solitary kidneys group and non-solitary kidneys group in this study.The two groups were compared and analyzed statistically in terms of demographic and clinical characteristics,operation time,stone-free rate,surgical-related complications rate and postoperative hospital stay.Result Successful access was achieved in all the patients.There was no significant difference between the two groups in terms of operation time,postoperative hospital stay,stone-free rate or surgical-related complications(fever,bleeding,renal faiure,steinstrasse or ureteral stricture)rate.The blood urea nitrogen(BUN)in both groups decreased significantly after the procedure(P<0.05),while the serum creatinine(SCr)were maintained similar to that before the procedure in two weeks with no significance(P>0.05)though it increased in the solitary kidneys group temporarily one day after the procedure with statistical significance(P<0.05).Conclusions Flexible ureteroscopy with holmium laser lithotripsy is safe and feasible for treating upper urinary stones in solitary kidneys,and could be recommended to clinical surgeons.