球囊扩张和输尿管导引鞘扩张在Ⅰ期输尿管软镜治疗肾结石中的应用对比研究

目的 研究球囊扩张和输尿管导引鞘扩张在I期输尿管软镜治疗肾结石中的应用。方法 将2017年7月至2017年12月在本院接受治疗并符合入选标准的拟行Ⅰ期输尿管软镜手术治疗的肾结石患者35例,作为研究对象,采用数字表随机分组的原则,分为观察组（采用球囊扩张的方式）与对照组（采用输尿管导引鞘扩张的方式）,观察并对比两组患者的一期治疗成功率、并发症情况以及住院时间和住院费用等社会指标的差异。结果 对比两组患者各项手术指标,结果发现手术时间、住院时间两项指标两组比较差异无统计学意义（P>0．05）,表明两种扩张方式并不会增加患者的痊愈时间,但观察组住院费用明显高于对照组,差异有统计学意义（P<0．05）;就两组患者治疗前后VAS评分而言,治疗前两组患者VAS评分无明显差异,治疗后两组患者差异无统计学意义（P>0．05）;分析两组患者并发症发生情况,结果观察组并发症发生率要明显低于对照组,差异有统计学意义（P<0．05）;分析两组患者手术成功率及结石清除率情况,结果两组患者结石清除率和手术成功率均较高,两组相比差异无统计学意义（P>0．05）。结论 从并发症角度分析,两种扩张方式均较安全,但球囊扩张组并发症发生率更低,但因球囊属于一次性医疗耗材,球囊扩张住院费费用要明显高于输尿管导引鞘扩张法。两种方法各有其优势,建议临床应用时酌情选择合适的方法。

Comparative study of balloon dilatation and ureteral guide sheath dilation in the treatment of renal calculi with flexible ureteroscopy

Objective  To explore the balloon dilatation and ureteral guide sheath expansion in the treatment of renal calculi with flexible ureteroscopy.Methods  From July 2017 to December 2017, 35 cases of renal calculi were treated by phase I ureteroscopy in our hospital. All patients were randomly divided into the observation group (using balloon dilatation) and the control group (using the ureteral guiding sheath dilatation）. Two groups of patients were observed in the first phase of treatment success, complications and hospitalization time and hospitalization expenses and other social indicators. Results  The results showed that there was no significant difference between the two indexes of the operation time and the time of hospitalization in the two groups. It showed that the two expansion methods did not increase the recovery time of the patients, but the hospitalization cost of the observation group was significantly higher than the control group (P<0．05), and the two groups of patients were evaluated before and after treatment. There was no significant difference in VAS scores between the two groups before treatment, and there was no significant difference between the two groups after the treatment (P>0．05). The incidence of complications in the two groups was analyzed, and the incidence of complications in the observation group was significantly lower than the control group (P<0．05). The surgical success rate of the two groups was analyzed and the results were analyzed. Stone clearance rate, the results of two groups of patients with stone clearance and surgical success rate were higher, there was no significant difference between the two groups (P>0．05).Conclusions   From the point of view of complications, the two types of dilatation are all safe, but the incidence of complications in the balloon dilatation group is lower, but the cost of balloon dilatation in hospitalization is significantly higher than ureteral guidance sheath expansion because of the balloon as a disposable medical consumable. The two methods have their own advantages. It is suggested that suitable methods should be chosen when clinical application.