输尿管软镜联合取石网篮治疗肾盏憩室结石的疗效分析

Efficiency of Flexible Ureteroscopic Lithotripsy with Holmium Laser for Treatment of Caliceal Diverticalar Calculi by Stone Basket

摘要: 目的：观察经尿道输尿管软镜(flexible ureterorenoscopy, F-URS)联合取石网篮治疗肾盏憩室结石的安全性和有效性。方法：回顾性分析2020年1月至2022年12月我院收治的56例肾盏憩室结石患者，其中30例经输尿管软镜联合取石网篮治疗。根据治疗方法不同分实验组(n = 30)和对照组(n = 26)。实验组采用经尿道F-URS钬激光碎石术联合取石网篮治疗，对照组采用常规行经尿道F-URS钬激光碎石术治疗。比较两组的手术时间、碎石时间、结石清除率、住院时间、并发症等情况。结果：实验组平均手术时间(81.60 ± 15.60) min低于对照组(102.23 ± 29.15) min，差异有统计学意义(P < 0.05)；实验组结石清除率分别为83.33% (25/30)，高于对照组53.84% (14/26)，差异均有统计学意义(P < 0.05)；尿源性感染并发症实验组为6.67% (2/30)，明显低于对照组26.92% (7/26)，差异有统计学意义(P < 0.05)；两组患者平均住院时间比较，差异无统计学意义(P > 0.05)。术后随访6个月~2年，实验组结石复发率为3.33% (1/30)，对照组复发率为26.92% (7/26)，差异有统计学意义(P < 0.05)。结论：经尿道F-URS钬激光碎石术联合取石网篮治疗肾盏憩室结石与常规行经尿道F-URS钬激光碎石术对比，能缩短手术时间、提高结石清除率、减少手术并发症，是治疗肾中、上盏憩室结石的有效方法。

Abstract: Objective: To observe the efficiency of flexible ureteroscopic (F-URS) lithotripsy with holmium laser for treatment of caliceal diverticalar calculi by stone basket. Methods: Between January 2020 to December 2022, 30 cases of caliceal diverticalar calculi were treated with flexible ureteroscopic lithotripsy using holmium laser by stone basket and 26 cases of routine transurethral F-URS holmium laser lithotripsy in No.906 Hospital of Joint Services Force of PLA. Their data were retrospectively analyzed. The operation time, stone free rate, hospital stay and complications were compared between the two groups. Results: In the F-URS combined with stone basket group and conventional F-URS group, the mean operation time was (81.60 ± 15.60) vs (102.23 ± 29.15) min. The stone free rate was 83.33% (25/30) vs 53.84% (14/26), urinary infection was 6.67% (2/30) vs 26.92% (7/26). There were statistically significant differences between the two groups (P < 0.05). There were no significant differences in the average hospitalization time between the two groups (P > 0.05). During the follow-up of 6~24 months, the recurrence rate was 3.33% (1/30) in the F-URS combined with stone basket group and conventional F-URS group 26.92% (7/26). There were statistically significant differences between the two groups (P < 0.05). Conclusions: The F-URS lithotripsy with holmium laser is Safer and more effective in the stone basket group than in the conventional group, especially for the treatment of calculus in the middle and upper calyx diverticulum.