上尿路结石应用组合式输尿管软镜治疗的研究进展
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摘要
目的研究上尿路结石应用组合式输尿管软镜治疗的临床应用效果,并讨论其研究进展和发展方向。方法调取该院自2013年以来的上尿路结石患者280例作为研究对象,采用组合式输尿管软镜结合钬激光碎石术进行治疗,其中输尿管结石患者164例,肾结石患者116例。结石大小13~23 mm 97例,24~29 mm的103例,≤30 mm的80例。对患者进行碎石治疗后观察患者碎石清除率、手术时间以及并发症情况。结果输尿管上端结石与肾结石组均为一次进镜成功,差异无统计学意义(P>0.05)。输尿管结石碎石率和清除率高于肾结石组,并且输尿管结石组手术时间短于肾结石组。按照结石大小分组,13~23 mm组均为一次进镜,碎石率、清除率、手术时间差异无统计学意义。术后并发症中,10例患者出现寒战、发热的症状,2例患者出现低血压、休克症状,但是通过治疗能完全治愈。结论组合式输尿管软镜对探查上尿路结石位置和大小有较高的准确率,结合钬激光碎石术能够安全、有效的治疗上尿路结石和肾结石,值得在临床推广使用。
Objective To research the clinical application effect of combined flexible ureteroscope in treatment of upper urinary calculi and discuss the research progress and development direction.Methods 280 cases of patients with upper urinary calculi in our hospital since 2013 were selected and treated with combined flexible ureteroscope and holmium laser lithotripsy,including 164 cases of patients with ureteral calculus and 116 cases with kidney stone,and the stone size of 97 cases was between 13 mm and 23 mm and of 103 cases was between 24 mm and 29 mm and of 80 cases was ≤30 mm,after treatment,the stone clearance rate,operation time and complications of the patients were observed.Results The ureter upper end calculus group and renal calculus group inserted into the ureter successfully by one time,and the difference had no statistical significance(P>0.05),and the detritus rate and clearance rate in the urinary calculi group were higher than those in the kidney stone group,and the operation time in the urinary calculi group was shorter than that in the kidney stone group,and the patients whose stone size was between 13 mm and 23 mm had inserted into the mirror by one time,and the differences in the lithotripsy rate,clearance rate and operation time had no statistical significance,in terms of the postoperative complications,10 cases were with shiver and fever,2 cases with hypotension and shock,but the patients can be totally cured after treatment.Conclusion The accurate rate of combined flexible ureteroscope in exploring the location and size of supper urinary calculi is higher,and the combined flexible ureteroscope and holmium laser lithotripsy can safely and effectively treat the upper urinary calculi and kidney stone,which is worth clinical promotion and application.
Objective To research the clinical application effect of combined flexible ureteroscope in treatment of upper urinary calculi and discuss the research progress and development direction.Methods 280 cases of patients with upper urinary calculi in our hospital since 2013 were selected and treated with combined flexible ureteroscope and holmium laser lithotripsy,including 164 cases of patients with ureteral calculus and 116 cases with kidney stone,and the stone size of 97 cases was between 13 mm and 23 mm and of 103 cases was between 24 mm and 29 mm and of 80 cases was ≤30 mm,after treatment,the stone clearance rate,operation time and complications of the patients were observed.Results The ureter upper end calculus group and renal calculus group inserted into the ureter successfully by one time,and the difference had no statistical significance(P>0.05),and the detritus rate and clearance rate in the urinary calculi group were higher than those in the kidney stone group,and the operation time in the urinary calculi group was shorter than that in the kidney stone group,and the patients whose stone size was between 13 mm and 23 mm had inserted into the mirror by one time,and the differences in the lithotripsy rate,clearance rate and operation time had no statistical significance,in terms of the postoperative complications,10 cases were with shiver and fever,2 cases with hypotension and shock,but the patients can be totally cured after treatment.Conclusion The accurate rate of combined flexible ureteroscope in exploring the location and size of supper urinary calculi is higher,and the combined flexible ureteroscope and holmium laser lithotripsy can safely and effectively treat the upper urinary calculi and kidney stone,which is worth clinical promotion and application.
引文
[1]卢剑,肖春雷,张树栋,等.新型组合式输尿管软镜治疗上尿路结石的初步体会[J].中国微创外科杂志,2010,10(6):517-519.
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[5]张鹏,种铁,杨小杰,等.组合式输尿管软镜联合U100plus激光治疗上尿路结石临床疗效及安全性分析[J].陕西医学杂志,2015,(7):816-818.
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[12]杨建军,杨关天,周翔,等.组合式输尿管软镜治疗输尿管上段结石17例[J].中华临床医师杂志:电子版,2013,7(13):198-199.
[13]刘春林,顾懿宁,徐彦,等.POLY输尿管软镜联合钬激光碎石治疗上尿路结石的基层推广应用价值(附65例报告)[C]//中华医学会.2015临床急重症经验交流第二次高峰论坛.北京:中国综合临床杂志,2015.
[14]李勇,王三富,唐建生,等.新型组合式输尿管软镜联合钬激光治疗上尿路结石的初步体会[J].湘南学院学报:医学版,2014,16(1):20-21.
[15]李钧,肖荆,郝钢跃,等.输尿管软镜钬激光碎石术治疗婴幼儿上尿路结石20例分析[J].现代泌尿外科杂志,2015,20(5):310-313.
[16]瞿伟,李永刚,钟鸿烈,等.组合式输尿管软镜联合钬激光治疗上尿路结石37例[J].现代医药卫生,2014,30(5):715-717.
[17]Kamran Tassaduqe,Muhammad Ali,Abdus Sala,et al.Studies on the Chemical Composition and Presentation of Urinary Stones in relation to Sex and Age among Human Population of Multan,Pakistan[J].Journal of Medical Sciences,2003,3(5):401.
[18]Yigit Akin,Selcuk Yucel,Ahmet Danisman,et al.The impact of metabolic risk management on recurrence of urinary stones[J].Journal of Health Sciences,2013,2(1).
[2]张西玲,刘春来,薛东炜,等.组合式输尿管软镜联合钬激光治疗上尿路结石52例报告[J].山东医药,2014,54(22):105.
[3]王韧,白春林,何涛,等.组合式输尿管软镜联合钬激光治疗上尿路结石的临床应用[J].临床和实验医学杂志,2014,13(22):1849-1850.
[4]张艳平,刘凯隆,路保赛,等.组合式输尿管软镜治疗泌尿系上尿路结石358例效果分析[J].河北医科大学学报,2016,37(10):1131-1134,1138.
[5]张鹏,种铁,杨小杰,等.组合式输尿管软镜联合U100plus激光治疗上尿路结石临床疗效及安全性分析[J].陕西医学杂志,2015,(7):816-818.
[6]肖旭,王强东,董振佳,等.组合式输尿管软镜钬激光碎石术治疗上尿路结石初步体会(附25例报告)[J].医药前沿,2015,5(36):191-192.
[7]梅傲冰,何翔,康婷,等.组合式输尿管软镜联合钬激光在上尿路结石的临床应用[J].饮食保健,2016,3(11):39-40.
[8]程伟,王靖宇,任瑞民,等.钬激光在新型组合式输尿管软镜治疗肾结石中的应用技巧[J].中国药物与临床,2014,14(10):1416-1418.
[9]肖峰,贾本忠,孙发,等.研究组合式输尿管软镜联合钬激光治疗上尿路结石的临床应用梅傲冰[J].饮食保健,2016,3(13):5-6.
[10]杨建军,杨关天,周翔,等.组合式输尿管软镜治疗上尿路结石应用体会(附65例报告)[J].医学信息,2015(19):27.
[11]徐华,高建邦,王鑫,等.新型组合式输尿管软镜钬激光碎石术治疗上尿路结石[J].微创泌尿外科杂志,2014(2):105-107.
[12]杨建军,杨关天,周翔,等.组合式输尿管软镜治疗输尿管上段结石17例[J].中华临床医师杂志:电子版,2013,7(13):198-199.
[13]刘春林,顾懿宁,徐彦,等.POLY输尿管软镜联合钬激光碎石治疗上尿路结石的基层推广应用价值(附65例报告)[C]//中华医学会.2015临床急重症经验交流第二次高峰论坛.北京:中国综合临床杂志,2015.
[14]李勇,王三富,唐建生,等.新型组合式输尿管软镜联合钬激光治疗上尿路结石的初步体会[J].湘南学院学报:医学版,2014,16(1):20-21.
[15]李钧,肖荆,郝钢跃,等.输尿管软镜钬激光碎石术治疗婴幼儿上尿路结石20例分析[J].现代泌尿外科杂志,2015,20(5):310-313.
[16]瞿伟,李永刚,钟鸿烈,等.组合式输尿管软镜联合钬激光治疗上尿路结石37例[J].现代医药卫生,2014,30(5):715-717.
[17]Kamran Tassaduqe,Muhammad Ali,Abdus Sala,et al.Studies on the Chemical Composition and Presentation of Urinary Stones in relation to Sex and Age among Human Population of Multan,Pakistan[J].Journal of Medical Sciences,2003,3(5):401.
[18]Yigit Akin,Selcuk Yucel,Ahmet Danisman,et al.The impact of metabolic risk management on recurrence of urinary stones[J].Journal of Health Sciences,2013,2(1).