上尿路结石应用组合式输尿管软镜治疗探究进展.docVIP

上尿路结石应用组合式输尿管软镜治疗探究进展 　　[摘要] 目的 研究上尿路结石应用组合式输尿管软镜治疗的临床应用效果，并讨论其研究进展和发展方向。 方法 调取该院自2013年以来的上尿路结石患者280例作为研究对象，采用组合式输尿管软镜结合钬激光碎石术进行治疗，其中输尿管结石患者164例，肾结石患者116例。结石大小13～23 mm 97例，24～29 mm的103例，≤30 mm的80例。对患者进行碎石治疗后观察患者碎石清除率、手术时间以及并发症情况。 结果 输尿管上端结石与肾结石组均为一次进镜成功，差异无统计学意义（P0.05）。输尿管结石碎石率和清除率高于肾结石组，并且输尿管结石组手术时间短于肾结石组。按照结石大小分组，13～23 mm组均为一次进镜，碎石率、清除率、手术时间差异无统计学意义。术后并发症中，10例患者出现寒战、发热的症状，2例患者出现低血压、休克症状，但是通过治疗能完全治愈。 结论 组合式输尿管软镜对探查上尿路结石位置和大小有较高的准确率，结合钬激光碎石术能够安全、有效的治疗上尿路结石和肾结石，值得在临床推广使用 [关键词] 上尿路结石；组合式输尿管软镜；钬激光碎石 [中图分类号] R691.4 [文献标识码] A [文章编号] 1674-0742（2017）03（b）-0189-03 [Abstract] Objective To research the clinical application effect of combined flexible ureteroscope in treatment of upper urinary calculi and discuss the research progress and development direction. Methods 280 cases of patients with upper urinary calculi in our hospital since 2013 were selected and treated with combined flexible ureteroscope and holmium laser lithotripsy， including 164 cases of patients with ureteral calculus and 116 cases with kidney stone， and the stone size of 97 cases was between 13mm and 23mm and of 103 cases was between 24mm and 29mm and of 80 cases was ≤30 mm， after treatment， the stone clearance rate， operation time and complications of the patients were observed. Results The ureter upper end calculus group and renal calculus group inserted into the ureter successfully by one time， and the difference had no statistical significance（P0.05）， and the detritus rate and clearance rate in the urinary calculi group were higher than those in the kidney stone group， and the operation time in the urinary calculi group was shorter than that in the kidney stone group， and the patients whose stone size was between 13mm and 23mm had inserted into the mirror by one time， and the differences in the lithotripsy rate， clearance rate and operation time had no statistical significance， in terms of the postoperative complications， 10 cases were with shiver and fever， 2 cases with hypotension and shock，