CAJ | 학술논문

目的探讨日间手术方式行输尿管镜下钬激光碎石术的可行性及安全性. 方法回顾性分析2010年10月至2011年9月采用输尿管镜下钬激光碎石术治疗的输尿管结石患者294例的临床资料.日间手术组147例,男100例,女47例.年龄19～74岁,平均47岁.结石直径0.5～2.5 cm,平均1.1 cm.住院手术组147例,男91例,女56例.年龄20～83岁,平均50岁.结石直径0.5～3.0 cm,平均1.2 cm.比较两组的等待入院时间、手术时间、碎石成功率、术中及术后并发症和住院费用等指标. 结果日间手术组与住院手术组手术时间分别为(46.4±16.5)、(52.1±18.3)min,差异无统计学意义(P＞0.05).碎石成功率日间手术组(95.9％)与住院手术组(92.5％)比较差异无统计学意义(P＞0.05).日间手术组术中及术后并发症发生率(5.0％)略低于住院手术组(5.4％),但差异无统计学意义(P＞0.05).日间手术组等待入院时间(2.5±1.3)d,明显短于住院手术组(7.6±3.6)d,差异有统计学意义(P＜0.05).日间手术组人均费用5433.4元,住院手术组8612.9元,差异有统计学意义(P＜0.05). 结论日间手术方式行输尿管镜下钬激光碎石术可减少患者等待入院时间及住院时间,且住院费用低.术前充分评估病情,选择合适的患者有利于减少及控制术中及术后并发症的发生.输尿管镜下钬激光碎石术的日间手术是可行且安全的.
목적 탐토일간수술방식행수뇨관경하화격광쇄석술적가행성급안전성. 방법 회고성분석2010년10월지2011년9월채용수뇨관경하화격광쇄석술치료적수뇨관결석환자294례적림상자료.일간수술조147례,남100례,녀47례.년령19～74세,평균47세.결석직경0.5～2.5 cm,평균1.1 cm.주원수술조147례,남91례,녀56례.년령20～83세,평균50세.결석직경0.5～3.0 cm,평균1.2 cm.비교량조적등대입원시간、수술시간、쇄석성공솔、술중급술후병발증화주원비용등지표. 결과 일간수술조여주원수술조수술시간분별위(46.4±16.5)、(52.1±18.3)min,차이무통계학의의(P＞0.05).쇄석성공솔일간수술조(95.9％)여주원수술조(92.5％)비교차이무통계학의의(P＞0.05).일간수술조술중급술후병발증발생솔(5.0％)략저우주원수술조(5.4％),단차이무통계학의의(P＞0.05).일간수술조등대입원시간(2.5±1.3)d,명현단우주원수술조(7.6±3.6)d,차이유통계학의의(P＜0.05).일간수술조인균비용5433.4원,주원수술조8612.9원,차이유통계학의의(P＜0.05). 결론 일간수술방식행수뇨관경하화격광쇄석술가감소환자등대입원시간급주원시간,차주원비용저.술전충분평고병정,선택합괄적환자유리우감소급공제술중급술후병발증적발생.수뇨관경하화격광쇄석술적일간수술시가행차안전적.
Objective To investigate the feasibility and safety of day surgery holmium:YAG laser lithotripsy for urinary tract calculi.Methods A total of 294 cases of urinary tract calculi were treated with ureteroscopic holmium:YAG laser lithotripsy from October 2010 to September 2011.There were 147 cases for day surgery and 147 cases for inpatient surgery group.The time of waiting to be admitted,success rate,operative time,intraoperative and postoperative complications,hospitalization costs were analyzed in each group.Results The mean operative time of the day surgery group and the inpatient surgery group was 46.4± 16.5 and 52.1± 18.3 min.The difference in the mean operative time between the two groups was not statistically significant (P＞0.05).The stone free rate was not statistically significant between the day surgery group (95.9％) and the inpatient surgery group (92.5％,P＞0.05).The complication rate of the day surgery group was slightly lower than the inpatient surgery group (5.0％ VS 5.4％),but the differences between the two groups was not statistically significant (P＞0.05).The mean time of waiting to be admitted of the day surgery group was statistically shorter than the inpatient surgery group(2.5±1.3d VS 7.6±3.6 d,P＜0.05).Patients in the day surgery groups spent statistically less money than patients in the inpatient surgery group (5433.4 VS 8612.9,P＜0.05).Conclusions Day surgery for ureteroscopic holmium:YAG laser lithotripsy could be safe with lower costs and incidence of postoperative complications,faster postoperative recovery.Pre-operative adequately and selecting appropriate patients are helpful to reduce and control of intraoperative and postoperative complications.