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一次性超细输尿管软镜联合头端可弯曲负压吸引鞘在上尿路结石一期治疗中的应用效果

Efficacy of single-use flexible ureteroscopes combined with flexible tip negative pressure suction sheath in the primary treatment of upper urinary tract stones

    摘要
  • 摘要:
    目的 探讨一次性超细输尿管软镜联合头端可弯曲负压吸引鞘在上尿路结石一期治疗中的应用效果。
    方法 选取236例上尿路结石患者为研究对象。通过回顾分析，将患者分为研究组(n=118)和对照组(n=118)。研究组采用一次性超细输尿管软镜联合头端可弯曲负压吸引鞘进行治疗，对照组采用一次性超细输尿管软镜联合常规鞘进行治疗。比较2组术后疼痛程度视觉模拟评分法(VAS)、炎症指标、应激指标、肾功能指标以及并发症发生率、结石清除率。
    结果 术后1、2、3 d, 对照组患者VAS评分高于研究组，差异有统计学意义(P < 0.05)。术后1 d, 研究组C反应蛋白、白细胞介素-6和降钙素原以及去甲肾上腺素、皮质醇水平低于对照组，差异有统计学意义(P < 0.05)。术后1 d, 研究组尿素氮、血肌酐、尿酸、胱抑素C水平高于对照组，差异有统计学意义(P < 0.05)。研究组总并发症发生率为14.4%, 低于对照组的27.1%, 差异有统计学意义(P < 0.05)。研究组术后结石清除率为98.3%, 高于对照组的88.1%, 差异有统计学意义(P < 0.05)。
    结论 一次性超细输尿管软镜联合头端可弯曲负压吸引鞘在上尿路结石一期治疗中的应用效果较好，其可提高结石清除率，降低并发症发生率，减轻术后疼痛及炎症反应，以及促进患者肾功能恢复。

     

    Abstract:
    Objective To investigate the efficacy of single-use flexible ureteroscopes combined with flexible tip negative pressure suction sheath in the primary treatment of upper urinary tract stones.
    Methods A total of 236 patients with upper urinary tract stones were selected as study subjects. Through retrospective analysis, the patients were divided into study group (n=118) and control group (n=118). The study group was treated with single-use flexible ureteroscopes combined with flexible tip negative pressure suction sheath, while the control group received treatment with single-use flexible ureter oscopes combined with conventional sheath. The postoperative pain level Visual Analogue Scale (VAS), inflammatory markers, stress indicators, renal function parameters, complication rates and stone clearance rates were compared between the two groups.
    Results On the first, second, and third postoperative day, the VAS scores in the control group were significantly higher than those in the study group (P < 0.05). At 1 d after surgery, the levels of C-reactive protein, interleukin-6, procalcitonin, norepinephrine and cortisol in the study group were significantly lower than those in the control group (P < 0.05). Additionally, on the first postoperative day, the levels of urea nitrogen, serum creatinine, uric acid and cystatin C in the study group were significantly higher than those in the control group (P < 0.05). The overall complication rate in the study group was 14.4%, which was significantly lower than 27.1% in the control group (P < 0.05). The postoperative stone clearance rate in the study group was 98.3%, which was significantly higher than 88.1% in the control group (P < 0.05).
    Conclusion The combination of single-use flexible ureteroscopes and flexible tip negative pressure suction sheath exhibits superior efficacy in the primary treatment of upper urinary tract stones. This approach can enhance stone clearance rates, reduces complication rates, alleviate postoperative pain and inflammatory responses, and promotes renal function recovery.

     

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