[1]李泽宇,刘 沛,余泉锋,等.不同温度生理盐水灌注对经尿道输尿管镜碎石术疗效的影响[J].新乡医学院学报,2019,36(10):983-985.[doi:10.7683/xxyxyxb.2019.10.019]
 LI Ze-yu,LIU Pei,YU Quan-feng,et al.Effect of saline infusion at different temperature on the efficacy of transurethral ureteroscopic lithotripsy[J].Journal of Xinxiang Medical University,2019,36(10):983-985.[doi:10.7683/xxyxyxb.2019.10.019]
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不同温度生理盐水灌注对经尿道输尿管镜碎石术疗效的影响
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《新乡医学院学报》[ISSN:1004-7239/CN:41-1186/R]

卷:
36
期数:
2019年10
页码:
983-985
栏目:
临床研究
出版日期:
2019-10-05

文章信息/Info

Title:
Effect of saline infusion at different temperature on the efficacy of transurethral ureteroscopic lithotripsy
作者:
李泽宇刘 沛余泉锋张冠英吴春磊
(新乡医学院第一附属医院泌尿外科二病区,河南 卫辉 453100)
Author(s):
LI Ze-yuLIU PeiYU Quan-fengZHANG Guan-yingWU Chun-lei
(Department of Urology,the First Affiliated Hospital of Xinxiang Medical University,Weihui 453100,Henan Province,China)
关键词:
经尿道输尿管镜碎石术40 ℃生理盐水结石清除率
Keywords:
ureteroscopic lithotripsy40 ℃ salinestone clearance rate
分类号:
R693+.4
DOI:
10.7683/xxyxyxb.2019.10.019
文献标志码:
A
摘要:
目的 探讨不同温度生理盐水灌注对经尿道输尿管镜碎石术(URL)疗效的影响。 方法 选择2017年7月至2018年7月在新乡医学院第一附属医院行经尿道输尿管镜碎石术的169例输尿管结石患者为研究对象,根据术中使用灌注液温度的不同将患者分为对照组(n=89)和观察组(n=80)。对照组患者术中使用22~25 ℃生理盐水进行灌注,观察组患者使用40 ℃生理盐水进行灌注。比较2组患者手术时间、术中结石上移率、术后4周结石清除率及并发症发生率。结果 观察组患者手术时间短于对照组(P<0.05)。对照组和观察组患者术中结石上移率分别为33.7%(30/89)、12.5%(10/80),观察组患者术中结石上移率显著低于对照组(χ2=10.488,P<0.05)。术后4周对照组和观察组患者结石清除率分别为71.9%(64/89)、93.8%(75/80),观察组患者结石清除率高于对照组(χ2=13.764,P<0.05)。观察组和对照组患者术后需再次行URL或体外冲击波碎石术(ESWL)率分别为6.3%(25/89)、28.1%(5/80),观察组患者术后需再次行URL或ESWL率显著低于对照组(χ2=13.764,P<0.05)。对照组患者发生出血19例(21.3%),进镜失败8例(9.0%),输尿管黏膜撕裂7例(7.9%);观察组患者发生出血16例(20.0%),进镜失败1例(1.3%),输尿管黏膜撕裂2例(2.5%);2组患者出血发生率和输尿管黏膜撕裂率比较差异均无统计学意义(χ2=0.047、2.405,P>0.05),观察组患者进镜失败率显著低于对照组(χ2=5.004,P<0.05)。 结论 URL中使用40 ℃生理盐水灌注可以提高手术成功率和结石清除率,缩短手术时间,降低进镜失败发生率。
Abstract:
Objective To explore the effect of saline infusion at different temperature on the efficacy of transurethral ureteroscopic lithotripsy (URL).Methods A total of 169 patients who underwent URL in the First Affiliated Hospital of Xinxiang Medical University from July 2017 to July 2018 were enrolled.The patients were divided into control group(n=89)and observation group(n=80)according to the temperature of perfusion fluid used during operation.The patients in the control group were perfused with 22-25 ℃ saline,the patients in the observation group were perfused with 40 ℃ saline.The operation time,intraoperative stone upward movement rate,stone clearance rate at 4 weeks after operation and complication rate were compared between the two groups.Results The average operation time of patients in the observation group was shorter than that in the control group (P<0.05).The intraoperative stone upward movement rate of patients in the control group and observation group was 33.7% (30/89) and 12.5% (10/80),respectively;the intraoperative stone upward movement rate of patients in the observation group was significantly lower than that in the control group (χ2=10.488,P<0.05).The stone clearance rate of patients in the control group and observation group was 71.9% (64/89) and 93.8% (75/80) respectively at 4 weeks after operation;the stone clearance rate of patients in the observation group was higher than that in the control group (χ2=13.764,P<0.05).The rate of requiring URL or extracorporeal shock wave lithotripsy (ESWL) again after operation in the observation group and the control group was 6.3%(5/80) and 28.1%(25/89) respectively;the rate of requiring URL or ESWL in the observation group was significantly lower than that in the control group (χ2=13.764,P< 0.05).In the control group,there were 19 cases (21.3%) of bleeding,8 cases (9.0%) of failure of entering of endoscopy,7 cases (7.9%) of tear of ureteral mucosa;in the observation group,there were 16 cases (20.0%) of bleeding,1 case (1.3%) of failure of endoscopy,2 cases (2.5%) of tear of ureteral mucosa.There was no significant difference in the incidence of bleeding and tear of ureteral mucosa between the two groups (χ2=0.047,2.405;P>0.05);the failure rate of entering of endoscopy in the observation group was significantly lower than that in the control group (χ2=5.004,P<0.05).Conclusion  In URL,the use of 40 ℃saline infusion can improve the success rate of surgery and stone clearance rate,shorten the operation time and reduce the failure rate of entering of endoscopy.

参考文献/References:

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更新日期/Last Update: 2019-10-05