硬膜外导管联合EMS钬激光在输尿管镜碎石中的应用研究

doi:10.19558/j.cnki.10-1020/r.2020.02.007

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摘要 目的：分析硬膜外导管联合EMS钬激光治疗输尿管结石的临床效果。方法：将2017年1月–2018年6月行输尿管镜结石碎石手术的患者120例纳入研究,并随机分为两组,每组60例。实验组采用硬膜外导管联合EMS钬激光碎石,对照组采用国产大功率60 W钬激光碎石,分析两组患者的手术时间,结石清石率、逃逸率和出血量、发热、疼痛及输尿管狭窄等并发症发生情况,评价硬膜外导管联合EMS钬激光治疗输尿管结石的安全性及有效性。结果：实验组手术时间20~30 min,术中无明显出血,碎石全部成功,术后发热2例,疼痛2例,对症治疗后好转,未进行其他特殊处理。对照组手术时间30~55 min,术中7例由于结石逃逸改为其他手术方式,术后发热9例,疼痛10例,对症治疗后症状消失。术后随访6~12个月,对照组有5例合并输尿管狭窄,实验组未发生输尿管狭窄,两组间手术时间、术后并发症发生率,结石逃逸率等方面差异有统计学意义。结论：硬膜外导管联合EMS钬激光治疗输尿管结石视野清晰,引流更加充分,手术时间短,结石位移不明显,较传统输尿管硬镜碎石具有更加明显的优势。

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	邵敬会
	臧洪学
	刘强
	李帅彪

关键词 ：输尿管结石, 硬膜外导管, EMS激光, 输尿管镜

Abstract：Objective：To analyze the clinical effectiveness of epidural catheter combined with EMS Holmium laser in the treatment of ureteral stones. Methods： From January 2017 to June 2018, 120 patients who were admitted to our hospital and needed ureteroscopy and lithotripsy were included in the study and randomly divided into two groups, 60 in each group. The experimental group was treated with epidural catheter combined with EMS Holmium laser lithotripsy, and the control group was given domestic high-power 60 Watt Holmium laser lithotripsy. The operative time, stone clearing rate, escape rate, bleeding volume, and incidence of complications such as fever, pain and ureteral stenosis were analyzed in two groups. The safety and effectiveness of epidural catheter combined with EMS holmium laser for ureteral calculi were evaluated. Results： The operative time in the experimental group was 20 to 30 min. No significant bleeding occurred during the operation. The lithotripsy was all successful. There were 2 cases of fever after operation and 2 cases of pain. The symptoms were improved after symptomatic treatment, and no other special treatment was given. In the control group, the operative time was 30 to 55 min. During the operation, 7 cases were converted to other surgical methods due to stone escape. The postoperative fever occurred in 9 cases and the pain in 10 cases. The symptoms disappeared after symptomatic treatment. During the follow-up period of 6-12 months, there were 5cases of ureteral stricture in the control group, and no ureteral stricture occurred in the experimental group. There were significant differences in the operative time, the incidence of postoperative complications, and the rate of stone escape between the two groups. Conclusion： Epidural catheter combined with EMS holmium laser in the treatment of ureteral calculi has a clear field of vision, more sufficient drainage, short operative time, and inconspicuous stone displacement, which has more obvious advantages than traditional ureteral hard lithotripsy.

Key words： ureteral calculi epidural catheter EMS laser ureteroscope

收稿日期: 2019-04-02

ZTFLH:

R692.4

基金资助:河北省重点研发计划项目（182777162）

通讯作者: 臧洪学,zanghx6000@163.com

引用本文:

邵敬会, 臧洪学, 刘强, 李帅彪. 硬膜外导管联合EMS钬激光在输尿管镜碎石中的应用研究[J]. 微创泌尿外科杂志, 2020, 9(2): 101-105.
SHAO Jinghui, ZANG Hongxue, LIU Qiang, LI Shuaibiao. Application of epidural catheter combined with EMS holmium laser in ureteroscopic lithotripsy. JOURNAL OF MINIMALLY INVASIVE UROLOGY, 2020, 9(2): 101-105.

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http://journal20.magtechjournal.com/Jwk_zgmnwk/CN/abstract/abstract1579.shtml 或 http://journal20.magtechjournal.com/Jwk_zgmnwk/CN/Y2020/V9/I2/101

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