两种套石网篮在输尿管软镜碎石取石术中应用的对比研究

Comparison on evaluation of two kinds of stone baskets using in flexible ureteroscopy

摘要:

目的：对比2种套石网篮在输尿管软镜碎石取石术中应用的效率和安全性。方法：75名进行输尿管软镜下碎石取石术的肾结石患者被随机分为2组，由同一组手术医师进行手术，A组患者在术中采用美国Boston Scientific公司的Escape镍钛合金结石回收篮（型号M0063902010）取石，B组患者在术中采用美国COOK公司的NCircle镍钛合金取石网篮（型号NTSE-022115-UDH）取石，比较2组患者取石效率、手术时间、清石率及并发症等情况。结果：平均取石时间A组患者为27 min，B组患者为35 min，平均每分钟最快取石次数A组患者为7.70次，B组患者为3.87次，术后1个月结石清除率A组患者为89.19%，B组患者为68.42%，上述3项数据均是A组患者优于B组患者，且差异有统计学意义。平均手术时间A组患者为68 min，B组患者为71 min，术后并发症发生率A组患者为5.41%，B组患者为5.26%，上述2项数据2组间差异无统计学意义。术中无出现套石网篮损伤患者集合系统及输尿管软镜情况。结论：2种套石网篮均可安全应用于输尿管软镜碎石取石术，选择适合的套石网篮有助于提高输尿管软镜碎石取石术的取石效率和结石清除率。

Abstract:

Objective：To compare the efficiency and safety of two kinds of stone baskets using in flexible ureteroscopy. Methods：Totally 75 patients with renal stones who underwent flexible ureteroscopy were randomly divided into two groups，and were treated by the same team of surgeons. For patients in group A，the stone fragment was catched out with Escape nitinol stone retrieval basket（Boston Scientific Corporation，USA，Catalog NO. M0063902010），and for patients in group B，the stone fragment was catched out with Ncircle nitinol tipless stone extractor（Cook Incorporated，USA，Catalog NO. NTSE-022115-UDH）. The clinical data such as basketing efficiency，operation time，stone free rate and complications were compared between two groups. Results：The average bas－keting time was 27 minutes in patients of group A，and 35 minutes in patients of group B. The average best basketing frequency in one minute was 7.70 in patients of group A，and 3.87 in patients of group B. The stone free rate one month after operation was 89.19% in patients of group A，and 68.42% in patients of group B. All these three clinical data of group A was superior to that of group B，and the difference had statistical meaning. The average operation time was 68 minutes in patients of group A，and 71 min－utes in patients of group B. The complication rate was 5.41% in patients of group A，and 5.26% in patients of group B. There was no statistical difference in these two clinical data. No damage occurred no matter in the collecting system of patients or in the ureter－scopes due to stone baskets. Conclusion：Both stone baskets are safe for flexible ureteroscopy. A suitable stone basket would improve the basketing efficiency and stone free rate of flexible ureteroscopy.