头端可弯一次性负压吸引鞘辅助FURL与PCNL用于输尿管上段合并肾结石患者的疗效对比

Comparison of the efficacy of disposable deflectable-tip negative-pressure suction sheath-assisted FURL versus PCNL in patients with upper ureteral calculi combined with renal calculi

摘要:

目的 探讨头端可弯一次性负压吸引鞘辅助输尿管软镜碎石术（FURL）与经皮肾镜碎石术（PCNL）用于输尿管上段合并肾结石患者的疗效对比。方法 选取2023年4月—2025年4月哈密市中心医院就诊的115例输尿管上段合并肾结石患者，其中61例接受头端可弯一次性负压吸引鞘辅助FURL治疗的患者作为观察组；另54例行PCNL的患者作为对照组。记录两组手术情况和术后并发症率。结果 两组手术时间、结石清除率比较，差异均无统计学意义（P >0.05）。观察组术中出血量低于对照组，术后住院时间短于对照组（P <0.05）。观察组术后并发症总发生率低于对照组（P <0.05）。两组术前1 d、术后1 d及术后2 d时视觉模拟评分法（VAS）评分比较，结果 ①不同时间点VAS评分比较，差异有统计学意义（P <0.05）；②两组VAS评分比较，差异有统计学意义（P <0.05），观察组VAS评分较低，镇痛效果较好；③两组VAS评分变化趋势比较，差异有统计学意义（P <0.05）。结论 与PCNL对比，头端可弯一次性负压吸引鞘辅助FURL用于输尿管上段合并肾结石患者效果显著，术后并发症少，疼痛轻，安全性较高。

Abstract:

Objective To comapre the efficacy between disposable deflectable-tip negative-pressure suction sheath-assisted flexible ureteroscopic lithotripsy (FURL) and percutaneous nephrolithotomy (PCNL) in patients with upper ureteral calculi combined with renal calculi.Methods A total of 115 patients with upper ureteral calculi complicated with renal calculi who were treated at Hami Central Hospital from April 2023 to April 2025 were enrolled in this study. Among them, 61 cases underwent FURL assisted by a disposable deflectable-tip negative-pressure suction sheath and were assigned to the observation group, and the other 54 patients underwent PCNL and were assigned to the control group. The surgical conditions and the incidence of postoperative complications were recorded for the two groups.Results There were no significant differences between the two groups in the operative duration or stone-free rate (both P > 0.05). The observation group had significantly lower intraoperative blood loss and a shorter postoperative hospital stay than the control group (both P < 0.05). The overall incidence of postoperative complications was significantly lower in the observation group than in the control group (P < 0.05). Visual analogue scale (VAS) scores were compared between the two groups at 1 day preoperatively, 1 day postoperatively, and 2 days postoperatively. The results showed that VAS scores differed significantly across time points (P < 0.05) and between the two groups (P < 0.05), with lower scores in the observation group, indicating better analgesic efficacy. The trends in VAS score changes over time differed significantly between the two groups (P < 0.05).Conclusion Compared with PCNL, the disposable deflectable-tip negative-pressure suction sheath-assisted FURL yields favorable outcomes in patients with upper ureteral calculi combined with renal calculi, with fewer postoperative complications, milder pain, and a higher safety profile.