目的 探讨输尿管软镜联合柔性可弯曲输尿管导引鞘在肾结石患者中的应用价值.方法 选择2022年1月至12月赣南医学院第三附属医院收治的40例肾结石患者作研究对象,按照随机数字表法分为对照组和观察组,每组各20例.两组均行输尿管软镜碎石术,对照组采用非可弯曲输尿管导引鞘,观察组采用柔性可弯曲输尿管导引鞘.比较两组的结石清除率、手术指标、疼痛程度、负性情绪、生活质量、并发症发生率.结果 观察组术后1 d及术后1个月的结石清除率均高于对照组,差异有统计学意义(P＜0.05).观察组的手术时间短于对照组,术中出血量少于对照组,差异有统计学意义(P＜0.05).术前,两组患者的疼痛程度、负性情绪、生活质量评分比较,差异无统计学意义(P＞0.05);观察组术后3 d的疼痛视觉模拟评分法(VAS)评分低于对照组,术后1个月的抑郁自评量表(SDS)、焦虑自评量表(SAS)评分低于对照组,术后1个月的世界卫生组织生活质量测定量表简表(WHOQOL-BREF)中社会关系、生理健康、心理健康、周围环境维度评分均高于对照组,差异有统计学意义(P＜0.05).观察组的并发症总发生率低于对照组,差异有统计学意义(P＜0.05).结论 输尿管软镜联合柔性可弯曲输尿管导引鞘较非可弯曲输尿管导引鞘在缩短手术时间、减少术中出血量等方面优势明显,利于提高结石清除率,降低并发症发生风险,减轻患者疼痛、负性情绪,改善生活质量.
Objective To explore the application value of flexible ureteroscope combined with flexible ureteral access sheath in patients with renal calculi.Methods A total of 40 patients with renal calculus admitted to the Third Affiliated Hospital of Gannan Medical University from January to December 2022 were selected as research objects.According to ran-dom number table method,they were divided into control group and observation group,with 20 cases in each group.Both groups were treated with flexible ureteroscopic lithotripsy.The control group was treated with non-flexible ureteral access sheath,while the observation group was treated with flexible ureteral access sheath.The stone clearance rate,surgical indi-cators,pain degree,negative emotions,quality of life,and incidence of complications were compared between the two groups.Results The stone clearance rate of the observation group at 1 day and 1 month after operation were higher than those of the control group,and the difference were statistically significant(P＜0.05).The operation time of the observation group was shorter than that of the control group,and the intraoperative blood loss was less than that of the control group,and the differ-ences were statistically significant(P＜0.05).Before operation,there were no statistically significant differences in pain de-gree,negative emotion and quality of life scores between the two groups(P＞0.05).The pain visual analogue scale(VAS)score of the observation group was lower than that of the control group 3 days after operation,the scores of self-rating de-pression scale(SDS)and self-rating anxiety scale(SAS)were lower than those of the control group 1 month after operation,and the scores of social relationship,physical health,mental health and surrounding environment in the World Health Orga-nization quality of life brief assessment(WHOQOL-BREF)1 month after operation were higher than those in the control group,and the differences were statistically significant(P＜0.05).The total incidence of complications in the observa-tion group was lower than that in the control group,and the difference was statistically significant(P＜0.05).Conclusion Flexible ureteroscope combined with flexible ureteral access sheath has obvious advantages in shortening the operation time and reducing intraoperative blood loss compared with non-flexible ureteral access sheath,which is conducive to improving the stone clearance rate,reducing the risk of complications,reducing the pain and negative emotions of patients,and im-proving the quality of life.
施胜龙;吕枚桥
赣南医学院第三附属医院泌尿外科,江西赣州 341000赣南医学院第一附属医院公共卫生科,江西赣州 341000
临床医学
肾结石;输尿管软镜;柔性可弯曲输尿管导引鞘;结石清除率;疼痛程度
Renal calculi;Flexible ureteroscopy;Flexible ureteral access sheath;Stone clearance rate;Degree of pain
《中国当代医药》 2024 (001)
47-50 / 4
江西省赣州市指导性科技计划项目(GZ2022ZSF373).
评论