智能控壓輸尿管軟鏡吸引取石術(shù)治療腎結(jié)石的臨床研究

鐘愉明 宋樂明 彭作鋒 朱倫鋒

摘 ? 要：目的 ?分析智能控壓輸尿管軟鏡吸引取石術(shù)治療腎結(jié)石的應(yīng)用價(jià)值。方法 ?選擇2017年9月～2018年6月在我院就診的68例腎結(jié)石患者作為研究對(duì)象，按照隨機(jī)數(shù)字表法分為對(duì)照組和觀察組，各34例。對(duì)照組患者采用經(jīng)皮腎鏡碎石術(shù)治療，觀察組患者采用智能監(jiān)控內(nèi)壓輸尿管軟鏡吸取石術(shù)治療。比較兩組患者手術(shù)時(shí)間、出血量、下床活動(dòng)時(shí)間、住院時(shí)間及術(shù)后并發(fā)癥發(fā)生情況。結(jié)果 ?對(duì)照組患者手術(shù)時(shí)間高于觀察組[（134.14±31.05）min vs（68.61±29.12）min]，術(shù)中出血量多于觀察組[（378.14±40.69）ml vs（205.04±31.64）ml]，差異均有統(tǒng)計(jì)學(xué)意義（P<0.05）;觀察組患者下床活動(dòng)時(shí)間、住院時(shí)間均短于對(duì)照組患者，差異有統(tǒng)計(jì)學(xué)意義（P<0.05）;觀察組并發(fā)癥發(fā)生率低于對(duì)照組（8.82% vs 35.29%），差異有統(tǒng)計(jì)學(xué)意義（P<0.05）。結(jié)論 ?智能控壓的輸尿管軟鏡吸引取石術(shù)應(yīng)用于腎結(jié)石中能有效縮短手術(shù)時(shí)間，減少術(shù)中出血量，加快患者下床活動(dòng)，減少患者住院時(shí)間，并發(fā)癥發(fā)生率低。

關(guān)鍵詞：智能控壓;壓力反饋;輸尿管軟鏡;腎結(jié)石

中圖分類號(hào)：R699.2 ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ?文獻(xiàn)標(biāo)識(shí)碼：A ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ?DOI：10.3969/j.issn.1006-1959.2018.24.023

文章編號(hào)：1006-1959（2018）24-0087-03

Abstract：Objective To analyze the application value of intelligent pressure-controlled ureteroscope for stone removal for the treatment of renal calculi. Methods ?A total of 68 patients with kidney stones who were treated in our hospital from September 2017 to June 2018 were enrolled. The patients were divided into the control group and the observation group according to the random number table method， 34 cases each. Patients in the control group were treated with percutaneous nephrolithotomy， and patients in the observation group were treated with intelligent monitoring of internal pressure ureteroscopy. The operation time， blood loss， time of getting out of bed， hospitalization time and postoperative complications were compared between the two groups. Results ?The operation time of the control group was higher than that of the observation group [（134.14±31.05） min vs （68.61±29.12） min]， and the intraoperative blood loss was more than that of the observation group [（378.14±40.69） ml vs（205.04±31.64） ml]. The differences were statistically significant （P<0.05）. The time of going out and the length of hospital stay in the observation group were shorter than those in the control group， the difference was statistically significant （P<0.05）. The incidence of complications in the observation group was lower than that in the control group. （8.82% vs 35.29%）， the difference was statistically significant （P<0.05）. Conclusion ?Intelligent pressure-controlled ureteroscope-assisted stone extraction for renal calculi can effectively shorten the operation time， reduce the amount of intraoperative blood loss， speed up the patient's getting out of bed， reduce the length of hospital stay， and have a low incidence of complications.

Key words：Intelligent pressure control;Pressure feedback;Ureteroscopy;Renal calculi

腎結(jié)石（renal calculi）為臨床常見的尿路結(jié)石，表現(xiàn)為腰部酸脹、隱痛、腎臟出現(xiàn)刀割樣劇烈疼痛，嚴(yán)重者造成腎膿腫、腎積水，甚至腎功能喪失，其中較難處理、較復(fù)雜的是巨形腎結(jié)石和多發(fā)腎結(jié)石[1]。據(jù)統(tǒng)計(jì)，腎結(jié)石的發(fā)病率為5%～15%，復(fù)發(fā)率高達(dá)50%[2]。國內(nèi)常見的治療方式為輸尿管軟鏡碎石術(shù)加套石籃取石術(shù)，但術(shù)中不能監(jiān)測和控制腎盂內(nèi)壓力，且取石時(shí)間長，這限制了輸尿管軟鏡的臨床應(yīng)用[2]。監(jiān)控腎內(nèi)壓力和提高手術(shù)效率仍是該手術(shù)急需解決的重要問題。目前，對(duì)于泌尿結(jié)石的治療已步入微創(chuàng)化時(shí)代，輸尿管軟鏡的出現(xiàn)，使得尿路結(jié)石的治療有了新的突破。輸尿管軟鏡聯(lián)合鈦激光碎石術(shù)具有創(chuàng)傷小、出血少、并發(fā)癥少等優(yōu)點(diǎn)，日益受到臨床醫(yī)生的親睞及患者的認(rèn)可，我院在使用軟鏡碎石的基礎(chǔ)上加用智能控壓的輸尿管軟鏡吸引取石術(shù)，取得了非常好的治療效果，現(xiàn)報(bào)告如下?！?br>