"无鞘无管"与"有管有鞘"在输尿管软镜碎石术中的疗效对比OA
Comparison of the Efficacy of Ureteroscopic Lithotripsy with and without Ureteral Access Sheath and Ureteral Stent
目的:探究肾结石患者输尿管软镜碎石术治疗中未使用输尿管通路鞘及支架与使用输尿管通路鞘及支架的疗效差异.方法:选择 2022 年 8 月—2025 年 8 月于甘肃陇南市第一人民医院就诊并行输尿管软镜碎石术治疗的 120 例肾结石患者作为研究对象.采用随机数表法分组,观察组在输尿管软镜碎石术治疗中未使用输尿管通路鞘及支架,对照组在输尿管软镜碎石术治疗中使用输尿管通路鞘及支架.比较两组术前临床资料、手术指标、术后 1 周及 1 个月清石率、术后并发症.结果:两组年龄、性别、身体质量指数(BMI)、结石直径、患侧、CT 值、结石手术史、结石位置、抗菌药物使用情况、C 反应蛋白、糖尿病、高血压患病情况等术前临床资料比较,差异无统计学意义(P＞0.05).两组住院时间、输尿管损伤情况、血红蛋白下降值比较,差异无统计学意义(P＞0.05),观察组手术时间、住院费用均低于对照组,差异有统计学意义(P＜0.05).观察组与对照组初始清石率及术后 1 个月清石率比较,差异无统计学意义(P＞0.05).两组并发症比较,差异无统计学意义(P＞0.05).结论:肾结石患者输尿管软镜碎石术治疗中未使用输尿管通路鞘及支架可缩短住院时间、减少住院费用,与输尿管软镜碎石术治疗中使用输尿管通路鞘及支架的疗效相当,可为临床肾结石患者的治疗提供参考.
Objective:To explore the differences in efficacy between the use and non-use of ureteral access sheaths and stents in flexible ureteroscopic lithotripsy for patients with kidney stones.Method:A total of 120 patients with kidney stones who underwent flexible ureteroscopic lithotripsy in the First People's Hospital of Longnan from August 2022 to August 2025 were selected.They were randomly divided into an observation group and a control group using a random number table as the research objects.The observation group did not use ureteral access sheaths and stents during flexible ureteroscopic lithotripsy,while the control group did.The preoperative clinical data,surgical indicators,stone clearance rates at 1 week and 1 month after surgery,and postoperative complications of the two groups were compared.Result:There were no statistically significant differences in preoperative clinical data such as age,gender,body mass index(BMI),stone diameter,affected side,CT value,history of stone surgery,stone location,use of antibiotics,C-reactive protein,diabetes,and hypertension between the two groups(P＞0.05).There were no statistically significant differences in the comparison of hospitalization time,ureteral injury conditions and hemoglobin decrease values between the two groups(P＞0.05).The operation time and hospitalization cost in the observation group were lower than those in the control group,and the differences were statistically significant(P＜0.05).There were no statistically significant differences in the initial stone clearance rates and the stone clearance rates at 1 month after surgery between the observation group and the control group(P＞0.05).There was no statistically significant difference in the complications between the two groups(P＞0.05).Conclusion:In flexible ureteroscopic lithotripsy for patients with kidney stones,not using ureteral access sheaths and stents can shorten the hospital stay and reduce hospitalization costs,and the efficacy is comparable to that of using ureteral access sheaths and stents,which can provide a reference for the clinical treatment of patients with kidney stones.
张亚军
甘肃陇南市第一人民医院 甘肃 陇南 746000
输尿管软镜碎石术肾结石输尿管通路鞘输尿管支架疗效
Flexible ureteroscopic lithotripsyKidney stonesUreteral access sheathUreteral stentEfficacy
《中外医学研究》 2026 (9)
33-36,40,5
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