头端可弯负压吸引鞘联合一次性输尿管软镜治疗多发肾结石的疗效分析

Efficacy of Tip-Bendable Suction Ureteral Access Sheath Combined with Disposable Flexible Ureteroscope in the Treatment of Multiple Renal Stones

摘要

目的:比较头端可弯负压吸引鞘(S-UAS)联合一次性输尿管软镜手术(RIRS)与经皮肾镜取石术(PCNL)治疗总直径为2~4 cm 的多发肾结石的安全性和有效性。方法:回顾性分析2024年1月—2025年4月在宜昌市中心人民医院泌尿外科收治的74例总直径为2~4 cm 的多发肾结石患者的临床资料。根据治疗方式不同分为行头端S-UAS联合 RIRS的观察组(n=35)和行 PCNL 的对照组(n=39),比较两组患者的临床疗效。结果:两组术后结石清除率分别为 71.43% 和76.92%,差异无统计学意义(P>0.05)。与对照组相比,观察组术后肌酐升高值、白细胞升高值、降钙素原升高值、白细胞介素-6升高值、疼痛评分、卧床时间、住院时间及住院费用均低于对照组,差异均具有统计学意义(均P<0.05)。观察组术后发热比例为5.71%,明显低于对照组23.08% (P<0.05)。结论:与PCNL相比,S-UAS联合 RIRS治疗总直径2~4 cm 多发肾结石在保证结石清除率的同时能显著降低感染风险,降低住院时间和住院费用,临床疗效显著。

Abstract

Objective: To compare the safety and efficacy of tip-bendable suction ureteral access sheath (S-UAS) combined with retrograde intrarenal surgery (RIRS) versus percutaneous nephrolithotomy (PCNL) for treating multiple renal stones with a total diameter 2 to 4 cm. Methods: A retrospective analysis was conducted on the clinical data of 74 patients with multiple kidney stones (total diameter 2 to 4 cm) at the Department of Urology, Yichang Central People's Hospital from January 2024 to April 2025. Patients were divided into two groups based on different treatment Methods: the observation group (n=35) underwent tip-bendable S-UAS combined with RIRS, and the control group (n=39) underwent PCNL. The clinical efficacy of the two groups was compared. Results: The postoperative stone-free rates were 71.43% and 76.92% in the two groups, respectively, and the difference was not statistically significant (P>0.05). Compared with the control group, the observation group had significantly lower increases in postoperative creatinine, white blood cell count, procalcitonin, interleukin-6, pain scores, bed-rest duration, hospital stay, and hospitalization costs, with all differences being statistically significant (all P<0.05). Moreover, the postoperative fever rate in the observation group was 5.71%, markedly lower than the 23.08% in the control group (P <0.05). Conclusion: Compared with PCNL, S-UAS combined with RIRS for treating multiple kidney stones with a total diameter 2 to 4 cm can significantly reduce the risk of infection while ensuring stone free rate, shorten length of stay, and reduce hospitalization costs, showing remarkable clinical efficacy.

关键词

负压吸引鞘 / 输尿管软镜手术 / 多发肾结石

Key words

suction ureteral access sheath (S-UAS) / retrograde intrarenal surgery (RIRS) / multiple renal stones

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基金资助

湖北省自然科学基金创新发展联合基金项目(2024AFD194)