【摘要】 目的探讨输尿管硬镜联合软镜治疗输尿管上段结石的临床效果。方法选择北京积水潭医院泌尿外科2011年2月~2015年2月收治的66例输尿管上段结石患者,根据随机数字表法分为治疗组与对照组,每组各33例,治疗组给予输尿管硬镜联合软镜下碎石治疗,对照组给予输尿管硬镜下碎石治疗,观察两组围手术指标、并发症与随访复发情况。结果所有患者顺利完成手术,治疗组的碎石时间、结石排净时间与术后住院时间都明显短于对照组(P<0.05)。术后14 d经过观察,治疗组的治疗有效率为93.9%,对照组为78.8%,差异有统计学意义(P<0.05)。治疗组术后14 d的恶心呕吐、肺部感染、疼痛、输尿管损伤等并发症发生情况明显少于对照组(P<0.05)。所有患者术后随访6个月,治疗组的复发率为3.0%(1/33),对照组为15.2%(5/33),治疗组术后复发率明显低于对照组(P<0.05)。结论输尿管硬镜联合软镜治疗输尿管上段结石具有很好的微创性,能提高治疗效果,并且减少术后并发症的发生,有很好的应用效果。更多还原

【Abstract】 Objective To investigate the clinical effects of ureteroscopic combined flexible ureteroscope for the ureteral calculi patients. Methods 66 patients with ureteral calculi in the department of Urinary Surgery of Beijing Jishuitan Hospital from February 2011 to February 2015 were selected and divided into treatment group and control group, with30 cases in each group according to random number table method. The treatment group were received ureteroscopic combined flexible ureteroscope therapy, the control group were only received ureteroscopic therapy. The perioperative treatment, complications and follow-up recurrence were observed. Results All operations were successfully completed,but the stone drain time, gravel time and hospital stay in the treatment group were significantly less than those of the control group(P < 0.05). Postoperative 14 d through observation, the effective rates in the treatment group and the control group were 93.9% and 78.8%, Difference was statistically significant(P < 0.05). The postoperative 14 d nausea and vomiting, lung infection, pain, ureteral injury complications in the treatment group were significantly less than those of the control group(P < 0.05). All patients were followed up for 6 months, the relapse rate in the treatment group was3.0%(1/33), and the control group were 15.2%(5/33), the treatment group recurrence rate was significantly lower than that of the control group(P < 0.05). Conclusion Ureteroscopic combined flexible ureteroscope for ureteral calculi patients has good minimally invasive, can improve the therapeutic effect and reduce the incidence of postoperative complications, which has very good application effects.更多还原