灵活真空辅助UAS的RIRS与MPCNL对受冲击的上尿路结石:一个前性,随机对照性研究
Qing-Lai Tang1, Ping Liang2, Ling-Hui Li3
1Department of Urology, The Affiliated Jiangning Hospital of Nanjing Medical University, Nanjing, Jiangsu, China.
Urolithiasis
|June 4, 2025
概括
具有灵活真空辅助尿道接入 (FV-UAS) 的逆行性内外科手术提供了可比的无石头率,可与对冲击性上尿道石头的最小侵入性皮肤穿nephrolithotomy相比较. 这种方法显著提高了生活质量,并减少了并发症.
科学领域:
- 泌尿器科 泌尿器科 泌尿器科 泌尿器科
- 最少侵入性的手术
- 腎石病的管理方法
背景情况:
- 受影响的上尿路结石 (IUUS) 是一个重大的临床挑战.
- 目前的治疗选择包括微创性皮肤透神经切除术 (MPCNL) 和逆行性内手术 (RIRS).
- 将RIRS与IUUS的柔性真空辅助尿道接入 (FV-UAS) 结合在一起的疗效和安全性需要进一步研究.
研究的目的:
- 为了比较RIRS与FV-UAS相结合的疗效和安全性,与MPCNL相比,用于治疗冲击性上尿管结石.
- 评估关键结果,包括无石头率,手术时间,血液损失,住院,生活质量和并发症.
主要方法:
- 一项涉及189名IUUS患者的比较研究,分为FV-UAS组 (95名患者) 和MPCNL组 (94名患者).
- 主要结局:术后第一天的无结石率 (SFRs).
- 二次结局:1个月后的SFR,手术时间,血红蛋白降低,住院,生活质量 (QoL) 评分,尿道狭窄发生率和并发症.
主要成果:
- 这两组在术后第一天和1个月后都显示出相似的无石头率.
- 在FV-UAS小组中,血红蛋白减少显著降低 (5.1比14.7g/L),住院时间缩短 (2.7比4.9天).
- 在FV-UAS组中,生活质量的改善显著更高 (32.5对27.1),整体并发症率明显较低.
结论:
- 与FV-UAS一起的RIRS是治疗受冲击的上尿路结石的有希望的替代方案,其结石清除率与MPCNL相比.
- FV-UAS在减少血液损失,缩短住院时间,提高生活质量和减少并发症方面提供了显著的优势.
- 这种技术代表了管理IUUS的有效和安全选择.
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