论文部分内容阅读
目的探讨输尿管软镜(FUS)术中联合超声定位治疗肾盏憩室结石的临床价值及疗效。方法回顾性分析2013年1月至2016年9月我院收治的42例肾盏憩室结石患者的临床资料,其中23例FUS联合超声定位钬激光碎石取石治疗,19例常规FUS钬激光碎石取石治疗。对两组的无石率、碎石成功率、出血量、住院时间、手术时间、并发症及是否复发等情况进行统计学分析。结果 FUS联合超声组与常规FUS组的平均手术时间分别为(115.7±49.8)min和(136.3±53.6)min,平均术中出血量(25.3±19.1)mL和(31.2±17.9)mL,差异具有统计学意义(P<0.05)。术后无石率、碎石成功率分别为65.2%(15/23)、47.4%(9/19)和82.6%(19/23)、63.2%(12/19),差异具有统计学意义(P<0.05)。术后随访6~28个月,超声组复发率1.3%(3/23),常规组复发率1.1%(2/19)。平均住院时间、并发症、复发率等两组差异无统计学意义(P>0.05)。结石大小与憩室位置影响碎石成功率,差异具有统计学意义(P<0.05)。结论 FUS联合超声定位治疗肾盏憩室结石与常规FUS相比,可更迅速准确地寻及憩室开口,是治疗肾盏憩室结石安全、有效的方法之一。建议对于<2cm的肾上、中盏憩室结石首选FUS联合超声定位治疗。
Objective To investigate the clinical value and curative effect of ureteroscopy combined with ultrasound in the treatment of calyceal diverticula calculus. Methods The clinical data of 42 cases of calyceal diverticula calculus admitted from January 2013 to September 2016 in our hospital were analyzed retrospectively. Twenty-three patients underwent FUS combined with ultrasound-guided holmium laser lithotripsy and 19 patients underwent conventional FUS holmium laser lithotripsy Stone treatment. The stoneless rate, success rate of lithotripsy, bleeding volume, length of hospital stay, operation time, complications and recurrence of the two groups were statistically analyzed. Results The average operative time was (115.7 ± 49.8) min and (136.3 ± 53.6) min in FUS combined with conventional FUS group, and the average blood loss was (25.3 ± 19.1) mL and (31.2 ± 17.9) mL, respectively Statistical significance (P <0.05). The rates of postoperative stoneless and gravel success were 65.2% (15/23), 47.4% (9/19), 82.6% (19/23) and 63.2% (12/19) respectively, with statistical significance ( P <0.05). The patients were followed up for 6 to 28 months. The recurrence rate was 1.3% (3/23) in the ultrasound group and 1.1% (2/19) in the conventional group. The average length of hospital stay, complications, recurrence rate and other two groups showed no significant difference (P> 0.05). The stone size and diverticular position affect the success rate of gravel, the difference was statistically significant (P <0.05). Conclusion FUS combined with ultrasound in the treatment of calyceal diverticulum stones compared with conventional FUS, more quickly and accurately find the diverticulum opening, is the treatment of calyceal diverticulum stone is safe and effective method. Recommended for <2cm of the kidney, Zhongliao diverticula stones preferred FUS combined ultrasound localization treatment.