铥激光联合末端可弯曲负压鞘治疗1~3 cm肾结石的疗效及术后感染的危险因素
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中国博士后科学基金面上项目(2022M722674);


Effetcs of thulium laser combined with tip-bendable suction ureteral access sheath in treating 1~3 cm kidney stones and the risk factors for postoper-ative infection
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    摘要:

    目的:探究铥激光联合末端可弯曲负压鞘治疗1~3 cm肾结石的疗效,并分析术后感染的危险因素。方法:回顾性分析156例1~3 cm肾结石患者的资料,其中观察组76例(铥激光联合末端可弯曲鞘治疗);对照组80例(铥激光联合负压吸引鞘治疗),比较两组患者围术期指标与结石清除率(SFR),并分析术后感染的危险因素。结果:与对照组相比,观察组患者手术时间更短、术后1 d SFR更高、术后并发症发生率更低(P<0.05),两组患者住院当天及术后1个月的SFR无统计学差异(P>0.05)。术后,两组患者白细胞、降钙素原、白细胞介素6水平均升高(P<0.05),但观察组低于对照组(P<0.05)。多元Logistic回归分析显示,手术时间长,结石>2 cm和术后1 d结石残留是术后感染的独立危险因素(P<0.05)。结论:使用铥激光联合末端可弯曲负压鞘,可提高近期SFR,降低手术时间,且术后并发症少。手术时间长,结石>2 cm和术后1 d结石残留是术后发生感染的独立危险因素。

    Abstract:

    Objective:To investigate the efficacy of thulium laser combined with tip-bendable suction ureteral access sheath in the treatment of 1~3 cm kidney stones,and analyze the risk factors for postoperative infection.Methods:A retrospective analysis was conducted on the data of 156 patients with 1~3 cm kidney stones,including an observation group(n=76,treated with thulium laser combined with tip-bendable suction ureteral access sheath)and a control group(n=80,treated with thulium laser combined with tradi-tional negative pressure sheath).The perioperative indicators and stone clearance rate(SFR)of the two groups of patients were com-pared and analyzed to explore the risk factors for postoperative infection.Results:Compared with the control group,the observation group had shorter surgery time,higher postoperative 1-day SFR,and lower incidence of postoperative complications(P<0.05),while there was no difference in hospitalization days and postoperative 1-month SFR(P>0.05).Both groups showed an increase in white blood cells,procalcitonin,and interleukin-6 after surgery(P<0.05),but the observation group was lower than the control group(P<0.05).Multiple Logistic regression showed that surgical time,stone size>2 cm,and residual stone size on the first day after surgery were independent risk factors for postoperative infection(P<0.05).Conclusion:The use of thulium laser combined with a tip-flexible terminal suction ureteral access sheath can improve short-term SFR,reduce surgical time,and have fewer postoperative complications.Surgical time,stones larger than 2 cm,and residual stones on the first day after surgery are independent risk factors for postoperative in-fection.

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鲍安;杜乾;庞昆;史晓如;周荣升;.铥激光联合末端可弯曲负压鞘治疗1~3 cm肾结石的疗效及术后感染的危险因素[J].川北医学院学报,2025,40(7):836-839 844.

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