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目的:研究输尿管导管留置技术在输尿管镜治疗输尿管上段结石的安全性和有效性。方法:2011年1月~2013年12月,采用输尿管镜气压弹道碎石术治疗输尿管上段结石共67例。其中术中使用输尿管导管留置技术20例(导管辅助组),常规碎石术47例(常规治疗组)。输尿管导管留置方法为:采用F3输尿管导管引导下输尿管镜跨过输尿管上段结石后留置F3输尿管导管,退出输尿管镜,固定输尿管导管。在预留的输尿管导管旁进镜至结石处进行碎石。比较两组病例的手术时间、手术并发症和结石清除率。结果:导管辅助组与常规治疗组的手术时间、并发症发生率差异无统计学意义,导管辅助组结石清除率优于常规治疗组(分别为100%和76.6%,χ2=5.6,P=0.026)。结论:输尿管导管留置技术的应用可以提高输尿管镜气压弹道碎石术治疗输尿管上段结石的结石清除率,且并未增加术中术后的并发症。
Objective: To study the safety and effectiveness of ureteral catheterization in the treatment of upper ureteral calculi by ureteroscopy. Methods: From January 2011 to December 2013, ureteroscopic pneumatic lithotripsy was performed in 67 patients with upper ureteral calculi. Among them, 20 cases of ureteral catheter indwelling technique (catheter-assisted group) and 47 cases of conventional lithotripsy (routine treatment group) were used intraoperatively. Ureteral catheter indwelling method: the use of F3 ureteral catheter guide ureteroscopy over the upper ureteral calculi retained F3 ureteral catheter, exit ureteroscopy, fixed ureteral catheter. In the reserve of ureteral catheter next to the stones to lithotripsy. The operation time, operative complications and stone clearance rate were compared between the two groups. Results: There was no significant difference in the operation time and complication rate between the catheter-assisted group and the conventional treatment group. The stone removal rate in the catheter-assisted group was superior to the conventional treatment group (100% vs 76.6%, χ2 = 5.6, P = 0.026 ). Conclusion: The application of ureteral catheterization can improve the stone clearance rate of ureteroscopic pneumatic lithotripsy in the treatment of upper ureteral calculi, and does not increase the intraoperative and postoperative complications.