69例输尿管镜下气压弹道碎石术临床治疗效果分析.docVIP

69例输尿管镜下气压弹道碎石术临床治疗效果分析 　　[摘要] 目的 对输尿管镜下进行的气压弹道碎石手术的实际疗效进行研究探讨。方法 整群选取自2013年8月―2015年7月收治的以138例输尿管结石患者为研究对象，将其随机划成观察组与对照组均为69例。对于对照组选择应用了体外超声波碎石的方法，对于观察组，选择应用了输尿管镜下进行的气压弹道碎石手术，然后对这两组患者的实际疗效与出现并发症的情况进行详细的对比。 结果 观察组结石排除率与一次碎石合格率分别是97.1%和100%，显著高于对照组（87.6%、80.2%），观察组的结石排出时间是（4.1±0.7）d，明显少于对照组（8.3±0.1）d；两组并发症发生率分别是13.0% 和15.9%，其差异无统计学意义（χ2=1.438，P0.05）。结论 输尿管镜下进行的气压弹道碎石，可以取得较好的疗效要，且术中安全性高，并具有较高的结石排出率，非常值得在临床推广应用。 中国论文网 /6/view-7248806.htm 　　[关键词] 气压弹道碎石；输尿管结石；输尿管镜 　　[中图分类号] R61 [文献标识码] A [文章编号] 1674-0742（2015）12（c）-0064-02 　　Clinical Treatment Effect Analysis of 69 Cases with Ureteroscopy Pneumatic Lithotripsy 　　LONG Rui-fa， LI Yun， DENG Jian-lin， JIANG Yi 　　Department of Urinary Surgery， People’s Hospital of Luxi County， Pingxiang， Jiangxi Province， 337200 China 　　[Abstract] Objective To research and discuss the actual curative effect of ureteroscopy pneumatic lithotripsy. Methods 138 cases of patients with ureteral calculus treated from August 2013 to July 2015 were selected as the research object and randomly divided into two groups with 69 cases in each， the control group were treated with in-vitro ultrasonic lithotripsy， the observation group were treated with ureteroscopy pneumatic lithotripsy， and then the actual curative effect and occurrence of complications of the two groups were compared in detail. Results The calculus elimination rate and the first pass yield of detritus in the observation group were obviously higher than those in the control group， （97.1%， 100% vs 87.6%， 80.2%）， the calculus elimination time in the observation group was obviously shorter than that in the control group，（4.1±0.7）d vs（8.3±0.1d， the incidence of complications of the two groups was respectively 13.0% and 15.9%， the differences had no obvious statistical significance（χ2=1.438，P0.05），存在可比性。 　　1.2 方法 　　对观察组实行的是输尿管镜气压胆道碎石的方法，需要在硬膜外麻醉状态下做治疗，患者取截石位，以输尿管导管将9.5F 输尿管镜导引到输尿管内，找到结石后，插进气压胆道碎石杆，最大程度靠近结石，轻压结石使其能够挨近输尿管壁，使气压胆道碎石机开始工作，气压调整到153～256 kPa范围内，把结石击成碎状，以取石篮或者取石钳把结石取出，将双 J 管留置 1