自体血凝块技术在输尿管软镜碎石中的应用

高五岳; 刘贝贝; 郭园园; 孙巍; 王成勇; 李立强; 徐亮; 刘建民

doi:10.16766/j.cnki.issn.1674-4152.003580

自体血凝块技术在输尿管软镜碎石中的应用

doi: 10.16766/j.cnki.issn.1674-4152.003580

蚌埠医科大学第一附属医院泌尿外科，安徽蚌埠 233004

基金项目:

安徽省高等学校自然科学研究重点项目 2023AH051938

安徽省卫生健康科研青年项目 AHWJ2023A30170

蚌埠医学院研究生科研创新计划项目 Byycx22130

蚌埠医科大学第一附属医院新技术项目 2024129

详细信息

通讯作者:
刘贝贝，E-mail：bb_dynasty@qq.com

中图分类号: R692.4
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出版历程
- 收稿日期: 2024-03-31
- 网络出版日期: 2024-09-05

Application of autologous blood clot technique in flexible ureteroscopic lithotripsy

Department of Urology, the First Affiliated Hospital of Bengbu Medical University, Bengbu, Anhui 233004, China

摘要

摘要: 目的通过在输尿管软镜联合钬激光碎石手术中应用自体血凝块技术的效果比较来评价自体血凝块技术的适用性和安全性。方法收集2022年6月—2024年2月于蚌埠医科大学第一附属医院行输尿管软镜联合钬激光碎石术的65例结石患者资料进行回顾性分析，按照是否使用自体血凝块技术分为观察组30例、对照组35例。分析并比较2组患者手术时间、术中取石次数、住院时间、术后残留2 mm结石例数、术后残留4 mm结石例数及并发症发生情况等。结果 2组患者年龄、性别、BMI、结石数量、结石位置以及累积结石大小差异均无统计学意义(P＞0.05)。观察组手术时间[(54.97±7.06)min]较对照组[(68.14±9.75)min]缩短，术中取石次数[(11.50±3.04)次]明显少于对照组[(20.77±3.36)次]，术后残留2 mm结石例数(8例)明显少于对照组(22例)，差异均有统计学意义(P＜0.05)。2组术后残留4 mm结石例数、住院时间及并发症发生率比较差异均无统计学意义(P＞0.05)。结论输尿管软镜联合钬激光碎石术中使用自体血凝块技术具有良好的适用性及安全性。能够缩短手术时间，减少术中取石次数，提高术后无结石率，使得临床无意义残余结石碎片的发生率最小化，从而可能降低结石复发率。
- 自体血凝块 /
- 残余碎片 /
- 输尿管软镜 /
- 无结石率
Abstract: Objective To evaluate the suitability and safety of autologous blood clot technique in flexible ureteroscopy combined with the holmium laser lithotripsy. Methods A retrospective analysis of 65 patients with ureteral calculi in the First Affiliated Hospital of Bengbu Medical University who underwent flexible ureteroscopy combined with the holmium laser lithotripsy was performed from June 2022 to February 2024. They were divided into two groups according to whether autologous blood clot technology was used or not: 30 cases in observation group and 35 cases in control group. The operative duration, the number of stone removal during operation, duration of hospital stay, the number of residual 2 mm stones, the number of residual 4 mm stones and complications were recorded for statistical analysis. Results There were no significant differences in age, sex, BMI, stone number, stone location and cumulative stone size between the two groups (P>0.05). The operation time of the observation group [(54.97±7.06) min] was shorter than that of the control group [(68.14±9.75) min], the number of intraoperative stone removal [(11.50±3.04) times] was significantly less than that of the control group [(20.77±3.36) times], and the number of cases of residual 2 mm stones after operation (8 cases) was significantly less than that of the control group (22 cases), and the differences were all statistically significant (P < 0.05). The number of residual 4 mm stones, duration of hospital stay and complications were insignificantly different (P>0.05). Conclusion The use of autologous blood clot technique has good applicability and safety in flexible ureteroscopy combined with the holmium laser lithotripsy. It could shorten the operation time, reduce the number of stone removal during operation, improve the postoperative stone free rate, and minimize the incidence of clinically insignificant residual fragments, potentially reduce stone recurrence.
- Autologous blood clot /
- Residual fragment /
- Flexible ureteroscope /
- Stone-free rate

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表 1 2组结石患者一般资料比较

Table 1. Comparison of general data between two groups

组别	例数	年龄 (x±s，岁)	性别[例(%)]		结石数量 (x±s，个)	BMI (x±s)	累积结石大小 (x±s，mm)	结石位置[例(%)]
组别	例数	年龄 (x±s，岁)	男性	女性	结石数量 (x±s，个)	BMI (x±s)	累积结石大小 (x±s，mm)	肾盂	下极	上极
观察组	30	48.70±11.77	16(53.3)	14(46.7)	1.43±0.57	24.27±2.10	17.33±3.03	19(63.3)	8(26.7)	3(10.0)
对照组	35	45.57±11.59	25(71.4)	10(28.6)	1.46±0.56	24.57±1.69	17.34±2.78	21(60.0)	9(25.7)	5(14.3)
统计量		1.077^a	2.271^b		0.213^a	0.649^a	0.013^a	0.275^b
P值		0.286	0.132		0.832	0.519	0.989	0.871
注：^a为t值，^b为χ²值。

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表 2 2组结石患者手术疗效指标比较

Table 2. Comparison of surgical efficacy indexes between two groups

组别	例数	手术时间 (x±s，min)	取石次数 (x±s，次)	住院时间 (x±s，d)	术后残留结石[例(%)]
组别	例数	手术时间 (x±s，min)	取石次数 (x±s，次)	住院时间 (x±s，d)	结石2 mm	结石4 mm
观察组	30	54.97±7.06	11.50±3.04	5.57±1.89	8(26.7)	5(16.7)
对照组	35	68.14±9.75	20.77±3.36	6.40±2.05	22(62.8)	12(34.3)
统计量		6.145^a	11.640^a	1.696^a	8.382^b	2.596^b
P值		＜0.001	＜0.001	0.095	0.004	0.107
注：^a为t值，^b为χ²值。

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