在局部麻醉下进行柔性尿路透镜,用于石头管理:初步探索和两年的经验
Yueqiang Peng1, Linfeng Wang1, Jiajia Jin2
1Department of Urology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China.
Postgraduate medicine
|September 29, 2023
概括
灵活尿道透镜 (f-URS) 的局部麻醉 (LA) 是治疗结石的安全和有效方法. 这种方法为全身麻醉提供了具有成本效益的替代方案,改善了患者的治疗结果和治疗的可访问性.
科学领域:
- 泌尿器科 泌尿器科 泌尿器科 泌尿器科
- 麻醉学 麻醉学
- 最少侵入性的手术
背景情况:
- 柔性尿道透视 (f-URS) 是尿路结石的关键治疗方法.
- 全身麻醉 (GA) 带来风险,增加成本.
- 局部麻醉 (LA) 是一种更安全,更容易获得的替代方案.
研究的目的:
- 评估LA对f-URS的可行性,安全性和有效性.
- 评估LA在中国诊断相关群体 (DRG) 时代的作用.
- 确定LA是否是f-URS的GA可行的替代方案.
主要方法:
- 在2021-2023年期间,对614名接受f-URS与LA的患者进行了回顾性分析.
- 评估无石头率,术后并发症和住院费用.
- 程序关键点和患者报告的疼痛评分 (VAS,STAI) 的文档.
主要成果:
- 实现了83.4%的无石头率,平均操作时间为44.12分钟.
- 报告的并发症率较低:18例发烧,12例尿道受伤,没有严重的并发症.
- 劳动力成本是最小的 (1.7%的DRG支付,约40美元),在囊插入过程中疼痛最高.
结论:
- 在LA下的f-URS是耐受良好,高效,安全和经济的.
- 在DRG时代,LA为f-URS提供了具有成本效益的麻醉选择.
- 这种方法提高了治疗的可访问性,并降低了患者的风险.
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