输尿管导管辅助顺行灌注在输尿管镜上段结石激光碎石中的应用

目的输尿管导管辅助顺行灌注在输尿管镜上段结石激光碎石中的应用。方法选取2016年1月至2017年1月本院泌尿外科行输尿管镜钬激光碎石术(URL)治疗输尿管上段结石的102例患者作为研究对象,根据是否采用输尿管导管辅助顺行灌注将研究对象分为研究组(51例)和对照组(51例),研究组患者在行输尿管镜钬激光碎石术之前将输尿管导管插入结石上方并留置,在采用钬激光碎石时持续注水辅助顺行灌洗,对照组则不采用顺行灌洗,记录两组患者手术一般情况,结石清除率,术后并发症发生率,并对评估结果进行对比分析。结果研究组的住院时间、质量费用与对照组相比差异无统计学意义(P>0.05),但研究组的手术时间显著低于对照组(P<0.05);研究组患者的结石清除率明显高于对照组(94.12%vs.68.63%);研究组患者的术后并发症发生率明显低于对照组(5.88%vs.19.61%)(P<0.05)。结论输尿管导管辅助顺行灌注配合输尿管镜上段结石激光碎石术治疗输尿管上段结石,能够保持手术过程中视野清晰,提高结石清除率,并减少术后并发症发生率,缩短手术时间,具有临床运用和推广意义。

Application of antegrade ureteral catheter-assisted perfusion in laser lithotripsy of upper ureteroscopic calculi

Objective To investigate the application of antegrade ureteral catheter-assisted perfusion in laser lithotripsy of upper ureteroscopic calculi.Methods From January 2016 to January 2017,102 patients with upper ureteral calculi treated by ureteroscopic holmium laser lithotripsy(URL)were selected as the study subjects.According to whether ureteral catheter-assisted anterograde perfu-sion was used,the study subjects were divided into study group(51 cases)and control group(51 cases).The study group received ureteral guidance before ureteroscopic holmium laser lithotripsy.The catheter was inserted above the stone and retained.When holmium laser lithotripsy was used,continuous water injection was used to assist antegrade lavage.The control group was not used antegrade lavage.The general situation of operation,stone clearance rate and the incidence of complications were recorded.The evaluation results were compared and analyzed.Results The operation time of the study group was significantly lower than that of the control group(P<0.05),but there was no significant difference in hospitalization time and quality cost between the study group and the control group(P>0.05).The stone clearance rate of the study group was significantly higher than that of the control group(94.12%vs.68.63%).The incidence of postoperative complications of the study group was significantly lower than that of the control group(5.88%vs.19.61%)(P<0.05).Conclusions Ureteral catheter-assisted anterograde perfusion combined with laser lithotripsy under ureteroscope for upper ureteral calculi can maintain clear vision during operation,improve stone clearance rate,and reduce the incidence of complications after operation.It has clinical application and popularization significance.