Zhang Meng,Chen Zhihong,Zhang Hongmei,et al.Comparison of F 4.8 visual nephroscope versus traditional rigid ureteroscope for ureteral stones in infants and children aged ≤36 months[J].Journal of Clinical Pediatric Surgery,2025,(07):647-651.[doi:10.3760/cma.j.cn101785-202410031-009]
F4.8可视肾镜联合钬激光与传统输尿管硬镜联合钬激光治疗婴幼儿输尿管结石的对比
- Title:
- Comparison of F 4.8 visual nephroscope versus traditional rigid ureteroscope for ureteral stones in infants and children aged ≤36 months
- Keywords:
- Infants; Ureteral Calculi; Ureteroscopy; Holmium Laser; Surgical Procedures; Operative
- 摘要:
- 目的 评估F4.8可视肾镜联合钬激光与传统输尿管镜联合钬激光治疗婴幼儿输尿管结石的安全性和有效性。方法 回顾性分析山东大学附属儿童医院泌尿外科于2021年6月至2024年6月实施手术的33例婴幼儿输尿管结石患者临床资料,根据手术方式分为观察组(使用F4.8可视肾镜,n=18)和对照组(使用传统输尿管镜,n=15)。观察组在一期手术中完成碎石;对照组在首次手术后留置双J管,再行二期手术。主要观察指标包括:手术时间、术后住院天数、住院费用、术后并发症发生率和一期结石清除率。结果 两组均顺利完成手术,无一例严重并发症发生。单因素分析发现:观察组与对照组手术时间[(25.5±4.8) min比(34.8±3.7) min]、住院时间[(2.9±0.3) d比(4.3±0.6) d]、住院费用[(1.58±0.11)万元比(1.73±0.09) 万元]相比,差异均有统计学意义(P<0.05)。结石成分(P=0.308)、术后并发症发生率(P=0.481)和一期结石清除率(P=0.465)差异均无统计学意义。多因素Logistic回归分析发现:结石成分是一期结石清除率(OR=0.207,95%CI:0.185~0.231,P<0.001)及术后并发症发生率(OR=1.992,95%CI:1.782~2.227,P< 0.001)的独立影响因素。结论 F4.8可视肾镜联合钬激光治疗婴幼儿输尿管结石有更高的安全性,体现在显著缩短手术时间、减少住院时长与医疗费用,并有效加快患儿术后恢复进程。结石成分是影响一期结石清除率和术后并发症发生率的独立相关因素。
- Abstract:
- Objective To evaluate the safety and efficacy of F 4.8 visual nephroscope with holmium laser versus traditional ureteroscope plus holmium laser for ureteral stones in infants and young children. Methods A retrospective analysis was conducted for 33 infants and young children (aged ≤36 months) operated for ureteral stones between June 2021 and June 2024.Based upon surgical approaches,they were assigned into two groups of experimental (F 4.8 visual nephroscope,n=18) and control group (traditional ureteroscope,n=15).Experimental group underwent a single-stage procedure for stone fragmentation whereas control group had a two-stage approach with double-J stenting initially followed by a second-stage operation.The primary outcome measures included operative duration,postoperative hospitalization stay,hospitalization expense,incidence of postoperative complications and single-stage stone-free rate. Results All procedures were successfully completed without severe complications.As compared to traditional ureteroscope group,F 4.8 visual nephroscope group demonstrated significantly shorter operative duration[(25.5±4.8) vs. (34.8±3.7) min],shorter hospitalization stay[(2.9±0.3) vs. (4.3±0.6) days]and lower hospitalization expense[(1.58±0.11) vs. (1.73±0.09) ten thousamd].All differences were statistically significant (P<0.05).There were no statistically significant differences in the incidence of postoperative complications (P=0.481),primary stone-free rate (P=0.465),or stone composition (P=0.308) between the two groups. Multivariate Logistic regression analysis identified stone composition as an independent factor influencing both single-stage stone-free rate (OR=0.207,95%CI:0.185-0.231,P<0.001) and postoperative complication rate (OR=1.992,95%CI:1.782-2.227,P<0.001). Conclusions The combination of the F 4.8 visual nephroscope and holmium laser demonstrates higher stone-free rates and enhanced safety in the treatment of ureteral stones in infants,as reflected by significantly shorter operative times,reduced hospital stays and medical expenses,and improved postoperative recovery. Stone composition has been identified as an independent factor influencing both the primary stone-free rate and the incidence of postoperative complications.
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备注/Memo
收稿日期:2024-10-14。
基金项目:山东省医药卫生科技项目(202306021028)
通讯作者:陈志鸿,Email:zhm-13@163.com