输尿管软镜联合负压吸引鞘碎石术治疗直径<1.5 cm嵌顿性输尿管上段结石患者的疗效及并发症
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陕西省自然科学基础研究计划项目(2020JM-370);


Efficacy and complications of flexible ureteroscope combined with FV-UAS in treating patients with incarcerated upper ureteral calculi with diameter<1.5 cm
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    摘要:

    目的:探究输尿管软镜联合负压吸引鞘碎石术(FV-UAS)治疗直径<1.5 cm嵌顿性输尿管上段结石(UDU)患者的临床疗效及并发症。方法:回顾性分析接受FV-UAS治疗的结石直径<1.5 cm的嵌顿性UDU患者的临床资料,将其纳入研究组(n=225);将同期在输尿管软镜碎石术中使用普通输尿管通道鞘治疗,结石直径<1.5 cm的嵌顿性UDU患者临床资料纳入对照组(n=227)。比较两组患者围术期指标、手术疗效及术前、术后3 d的血清炎症因子水平、应激反应相关因子水平、并发症总发生率。结果:与对照组比较,研究组手术时间和住院时间更短(P<0.05),术中出血量更低(P<0.05),结石清除率更高(P<0.05),手术治疗总有效率更高(P<0.05)。术后3 d,研究组血清CRP、IL-10、TNF-α、MAD、AOPP水平均低于同期对照组(P<0.05),血清GSH-PX、SOD水平均高于同期对照组(P<0.05)。研究组术后并发症总发生率低于对照组(P<0.05)。结论:FV-UAS治疗直径<1.5 cm的嵌顿性UDU,能提升治疗效果,减轻手术创伤造成的应激反应,减少术后并发症发生。

    Abstract:

    Objective:To explore the clinical efficacy and complications of flexible ureteroscopy combined with flexible vacuum-assisted ureteral access sheath(FV-UAS)in the treatment of patients with incarcerated upper ureteral calculi(UDU)with diameter<1.5 cm.Methods:The clinical data of patients with incarcerated UDU with diameter<1.5 cm who received FV-UAS were retrospec-tively analyzed and the patients were included in study group(n=225).The clinical data of 227 patients who used common ureteral access sheath during flexible ureteroscopic lithotripsy were collected during the same period and the patients were set as control group.The perioperative indicators,surgical efficacy,serum levels of inflammatory factors and oxidation factors before surgery and at 3 days af-ter surgery and occurrence of complications were compared between groups.Results:The surgical time and hospitalization time in study group were shortened,and the intraoperative blood loss was reduced,and the stone clearance rate was risen compared with that in control group(P<0.05),and the total effective rate of surgical treatment was higher compared with that in control group(P<0.05).At 3 days after surgery,the levels of serum CRP,IL-10,TNF-α,MAD and AOPP in study group were lower than those in control group(P<0.05)while the levels of serum GSH-PX and SOD were higher than those in control group(P<0.05).The total incidence rate of post-operative complications in study group was lower than that in control group(P<0.05).Conclusion:FV-UAS for incarcerated UDU with diameter<1.5 cm can effectively enhance the clinical efficacy,educe stress reactions caused by surgical trauma,and reduce the postoperative complications.

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胡伟强;杜岳峰;甘为民;张刘勇;王琰涛;王龙;.输尿管软镜联合负压吸引鞘碎石术治疗直径<1.5 cm嵌顿性输尿管上段结石患者的疗效及并发症[J].川北医学院学报,2025,40(5):569-572.

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  • 在线发布日期: 2025-07-09
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