Analysis of the efficacy of flexible ureteroscopic lithotripsy combined with negative pressure aspiration ureteral access sheath in the treatment of upper urinary tract calculi
输尿管软镜碎石术联合负压吸引输尿管导引鞘治疗上尿路结石的疗效分析

摘要

目的 探讨输尿管软镜碎石术联合负压吸引输尿管导引鞘治疗上尿路结石的疗效及安全性。方法 回顾性分析86例上尿路结石患者的临床资料（2022年1月至2025年1月），其中43例采用输尿管软镜碎石术联合负压吸引输尿管导引鞘治疗（双通道组），另43例采用输尿管软镜碎石术联合普通输尿管导引鞘治疗（单通道组）。结果 对比单通道组，双通道组的手术时间、术后住院时间均更短，术后无石率则更高（95.35% vs. 81.40%），均存在显著性差异（P＜0.05）。术后24h两组WBC、CRP水平均较术前显著升高（P＜0.05），但双通道组上述指标水平均显著低于单通道组（P＜0.05）。相比单通道组，双通道组术后的并发症总发生率明显更低（4.65% vs. 18.60%，P＜0.05）。结论 输尿管软镜碎石术联合负压吸引输尿管导引鞘（双通道）治疗上尿路结石，可缩短手术及住院时间，提高术后无石率，减轻术后炎症反应，降低并发症发生率，临床疗效及安全性更优。

Abstract

Objective To explore the efficacy and safety of flexible ureteroscopic lithotripsy combined with negative pressure aspiration ureteral access sheath in the treatment of upper urinary tract calculi.
Methods The clinical data of 86 patients with upper urinary tract calculi (from January 2022 to January 2025) were retrospectively analyzed. Among them, 43 cases were treated with flexible ureteroscopic lithotripsy combined with negative pressure aspiration ureteral access sheath (double-channel group), and the other 43 cases were treated with flexible ureteroscopic lithotripsy combined with conventional ureteral access sheath (single-channel group).
Results Compared with the single-channel group, the double-channel group had shorter operation time and postoperative hospital stay, and a higher postoperative stone-free rate (95.35% vs. 81.40%), with significant differences (P < 0.05). The levels of WBC and CRP in both groups were significantly increased 24 hours after the operation compared with those before the operation (P < 0.05), but the levels of these indicators in the double-channel group were significantly lower than those in the single-channel group (P < 0.05). The total incidence of postoperative complications in the double-channel group was significantly lower than that in the single-channel group (4.65% vs. 18.60%, P < 0.05).
Conclusion   Flexible ureteroscopic lithotripsy combined with negative pressure aspiration ureteral access sheath (double-channel) in the treatment of upper urinary tract calculi can shorten the operation and hospital stay, increase the postoperative stone-free rate, reduce postoperative inflammatory response, and lower the incidence of complications, with better clinical efficacy and safety.