中国微创外科杂志
中國微創外科雜誌
중국미창외과잡지
Chinese Journal of Minimally Invasive Surgery
2015年
11期
982-985
,共4页
徐遵礼%朱建平%张前兴%马丽英%闫朝松%常宏帆
徐遵禮%硃建平%張前興%馬麗英%閆朝鬆%常宏帆
서준례%주건평%장전흥%마려영%염조송%상굉범
输尿管结石%输尿管镜%超声碎石%气压弹道碎石
輸尿管結石%輸尿管鏡%超聲碎石%氣壓彈道碎石
수뇨관결석%수뇨관경%초성쇄석%기압탄도쇄석
Ureteral calculi%Ureteroscope%Ultrasonic lithotripsy%Pneumatic lithotripsy
目的:探讨输尿管镜联合超声碎石清石系统( EMS第5代)治疗复杂输尿管结石的临床疗效和安全性。方法回顾性比较我院2007年9月~2014年10月手术治疗63例复杂输尿管结石的临床资料,按手术方式分为2组:30例行输尿管镜联合超声碎石清石系统碎石术为超声碎石组(ultrasonic lithotripsy,UL),33例行输尿管镜联合气压弹道碎石术为气压弹道碎石组(pneumatic lithotripsy, PL)。比较2组手术成功率、手术时间、结石完全排出时间,并记录不良事件发生情况。结果 UL组手术成功率93.3%(28/30),明显高于PL组72.7%(24/33)(χ2=4.630,P=0.031)。 UL组手术时间(35.9±8.6)min,明显少于PL组(47.9±6.7)min(t=-6.208,P=0.000)。 UL组术后结石完全排出时间(16.7±6.7)d,明显短于PL组(27.0±6.9)d(t=-5.999,P=0.000)。2组术后并发症发生率分别为3.3%(1/30)和12.1%(4/33),无统计学差异(χ2=0.676,P=0.411)。随访57例,时间1~85个月,中位随访时间39个月,无输尿管狭窄等远期并发症发生。结论输尿管镜联合超声碎石清石系统治疗复杂输尿管结石安全、有效,具有碎石效率高,手术时间短的优点。
目的:探討輸尿管鏡聯閤超聲碎石清石繫統( EMS第5代)治療複雜輸尿管結石的臨床療效和安全性。方法迴顧性比較我院2007年9月~2014年10月手術治療63例複雜輸尿管結石的臨床資料,按手術方式分為2組:30例行輸尿管鏡聯閤超聲碎石清石繫統碎石術為超聲碎石組(ultrasonic lithotripsy,UL),33例行輸尿管鏡聯閤氣壓彈道碎石術為氣壓彈道碎石組(pneumatic lithotripsy, PL)。比較2組手術成功率、手術時間、結石完全排齣時間,併記錄不良事件髮生情況。結果 UL組手術成功率93.3%(28/30),明顯高于PL組72.7%(24/33)(χ2=4.630,P=0.031)。 UL組手術時間(35.9±8.6)min,明顯少于PL組(47.9±6.7)min(t=-6.208,P=0.000)。 UL組術後結石完全排齣時間(16.7±6.7)d,明顯短于PL組(27.0±6.9)d(t=-5.999,P=0.000)。2組術後併髮癥髮生率分彆為3.3%(1/30)和12.1%(4/33),無統計學差異(χ2=0.676,P=0.411)。隨訪57例,時間1~85箇月,中位隨訪時間39箇月,無輸尿管狹窄等遠期併髮癥髮生。結論輸尿管鏡聯閤超聲碎石清石繫統治療複雜輸尿管結石安全、有效,具有碎石效率高,手術時間短的優點。
목적:탐토수뇨관경연합초성쇄석청석계통( EMS제5대)치료복잡수뇨관결석적림상료효화안전성。방법회고성비교아원2007년9월~2014년10월수술치료63례복잡수뇨관결석적림상자료,안수술방식분위2조:30례행수뇨관경연합초성쇄석청석계통쇄석술위초성쇄석조(ultrasonic lithotripsy,UL),33례행수뇨관경연합기압탄도쇄석술위기압탄도쇄석조(pneumatic lithotripsy, PL)。비교2조수술성공솔、수술시간、결석완전배출시간,병기록불량사건발생정황。결과 UL조수술성공솔93.3%(28/30),명현고우PL조72.7%(24/33)(χ2=4.630,P=0.031)。 UL조수술시간(35.9±8.6)min,명현소우PL조(47.9±6.7)min(t=-6.208,P=0.000)。 UL조술후결석완전배출시간(16.7±6.7)d,명현단우PL조(27.0±6.9)d(t=-5.999,P=0.000)。2조술후병발증발생솔분별위3.3%(1/30)화12.1%(4/33),무통계학차이(χ2=0.676,P=0.411)。수방57례,시간1~85개월,중위수방시간39개월,무수뇨관협착등원기병발증발생。결론수뇨관경연합초성쇄석청석계통치료복잡수뇨관결석안전、유효,구유쇄석효솔고,수술시간단적우점。
Objective To investigate the curative effect and safety of ureteroscopy combined with ultrasonic lithotripsy ( EMS fifth generation) for complicated ureteral calculi. Methods A total of 63 patients with complicated ureteral calculi underwent operations in our hospital between September 2007 and October 2014, including 30 cases of ureteroscopy combined with ultrasonic lithotripsy ( UL group) and 33 cases of ureteroscopy combined with pneumatic lithotripsy ( PL group) .The successful rate of operation, operation time, time to calculi expulsion and complication were compared between the two groups.Adverse effects were recorded. Results The successful rate of operation was 93.3%(28/30) in the UL group and 72.7%(24/33) in the PL group (χ2 =4.630, P=0.031).The operation time was (35.9 ±8.6) min in the UL group and (47.9 ±6.7) min in the PL group (t=-6.208, P=0.000).The time for calculi expulsion was (16.7 ±6.7) d in the UL group and (27.0 ±6.9) d in the PL group (t=-5.999, P=0.000).There was no significant difference in complication rate between the two groups [3.3% (1/30) vs.12.1% (4/33),χ2 =0.676, P=0.411].Fifty-seven patients were followed up for 1 -85 months(median,39 months), without long-term complications occurred. Conclusion Ureteroscopy combined with ultrasonic pneumatic lithotripsy is safe and effective for the treatment of complicated ureteral calculi, having advantages of shorter operation time and higher efficiency.