CAJ | 학술논문

目的：探讨一种改良固定装置在输尿管镜钬激光碎石术治疗输尿管结石的临床效果。方法分别采用传统方法和改良方法进行碎石，传统方法为光纤直接进入输尿管镜操作鞘进行碎石，改良方法为以固定装置固定光纤后再进入输尿管镜操作鞘进行碎石。比较两组方法的碎石的效率、对输尿管黏膜的损伤程度、光纤的消耗率以及术后残石率。结果实验组碎石效率为1．76～4．58 cm2／min，平均（3．26±0．8）cm2／min，对照组碎石效率为1．24～3．75 cm2／min，平均（2．24±0．3）cm2／min，两组比较，实验组明显高于对照组（P＜0．05）。对照组光纤损耗率为0．009～0．065 cm／cm2，平均（0．026±0．002）cm／cm2，实验组光纤的损耗率为0．005～0．064 cm／cm2，平均（0．015±0．009） cm／cm2。实验组输尿管黏膜受损例数及程度少于对照组，实验组残石率为11．7，对照组为23．6，两组比较对照组明显大于实验组（ P＜0．05）。结论以改良固定装置固定光纤后再进入输尿管镜操作鞘进行碎石的方法优于传统方法。值得临床推广。
목적：탐토일충개량고정장치재수뇨관경화격광쇄석술치료수뇨관결석적림상효과。방법분별채용전통방법화개량방법진행쇄석，전통방법위광섬직접진입수뇨관경조작초진행쇄석，개량방법위이고정장치고정광섬후재진입수뇨관경조작초진행쇄석。비교량조방법적쇄석적효솔、대수뇨관점막적손상정도、광섬적소모솔이급술후잔석솔。결과실험조쇄석효솔위1．76～4．58 cm2／min，평균（3．26±0．8）cm2／min，대조조쇄석효솔위1．24～3．75 cm2／min，평균（2．24±0．3）cm2／min，량조비교，실험조명현고우대조조（P＜0．05）。대조조광섬손모솔위0．009～0．065 cm／cm2，평균（0．026±0．002）cm／cm2，실험조광섬적손모솔위0．005～0．064 cm／cm2，평균（0．015±0．009） cm／cm2。실험조수뇨관점막수손례수급정도소우대조조，실험조잔석솔위11．7，대조조위23．6，량조비교대조조명현대우실험조（ P＜0．05）。결론이개량고정장치고정광섬후재진입수뇨관경조작초진행쇄석적방법우우전통방법。치득림상추엄。
Objective To investigate the clinical effect of an improved fixing device in uholmium laser lithotripsy for ureteral stones with reteroscopic.Methods Applied the traditional method and improved method of gravel respectively, the traditional method was directly entering the ureteroscope operation sheath, improved methods was fixed optical fiber before entering the ureteroscope sheath.Efficiency compared two groups of gravel, urethral mucosa damage degree and fiber consumption and residual stone rate postoperative.Results The aggregate efficiency of experimental group was 1.76~4.58 cm2/min, the average (3.26 ±0.8) cm2/min, the control groupy was 1.24 ~3.75 cm2/min, the average (2.24 ±0.3) cm2/min, the experimental group was significantly higher than that in the control group (P<0.05).the fiber loss rate of control group was 0.009~0.065 cm/cm2, the average (0.026 ±0.002)cm/cm2, the experimental group was 0.005~0.064 cm/cm2, the average (0.015 ±0.009) cm/cm2 , the control group was significantly higher than the experimental group ( P<0.05).The of Damage degree of urethral mucosa in experimental group was less than that of the control group, residual stone rate in experimental group was11.7,the control group was 23.6.the control group was significantly higher than the experimental group (P<0.05).Conclusions The improved method is superior to fixed fiber before entering the ureteroscope sheath of the traditional method.It is worthy of clinical promotion.