目的 探讨顺行输尿管软镜治疗特殊类型输尿管中下段梗阻的临床疗效。方法　分析2024年1月至2026年5月广东省中西医结合医院收治了20例特殊类型输尿管中下段梗阻患者的临床资料，对患者手术时间、术前和术后的血红蛋白、肾积水及随访情况进行分析。结果　所有患者均一期完成手术，手术时间为（75.5±16.4）分钟，术前与术后第一天血红蛋白对比，有一定差异（t=6.141，P＜0.05），术前与术后1个月患侧肾积液对比，肾积液明显改善（t=3.937，P＜0.05）。结论　经皮肾通道顺行输尿管软镜治疗特殊类型输尿管中下段梗阻具有微创、安全、有效、并发症少、术后恢复快等优点，值得临床推广应用。

Objective To evaluate the clinical efficacy of antegrade flexible ureteroscopy in treating special types of middle and lower ureteral obstruction. Methods From January 2024 to May 2026, clinical data of 20 patients with special types of middle and lower ureteral obstruction admitted to Guangdong Provincial Hospital of Integrated Traditional Chinese and Western Medicine were analyzed. The operation time, preoperative and postoperative hemoglobin levels, hydronephrosis, and follow-up conditions of the patients were analyzed. Results All patients underwent successful single-stage surgery, with an average operative time of (75.5 ± 16.4) minutes. There was a significant difference in hemoglobin levels between preoperatively and on the first postoperative day (t = 6.141, P < 0.05). Hydronephrosis on the affected side showed marked improvement when comparing preoperative and one-month postoperative conditions (t = 3.937, P < 0.05). Conclusions Antegrade flexible ureteroscopy via percutaneous nephrostomy tract is a minimally invasive, safe, effective, and well-tolerated approach for treating special types of middle and lower ureteral obstruction, with few complications and rapid postoperative recovery, making it worthy of clinical promotion and application.

目的 探讨顺行输尿管软镜治疗特殊类型输尿管中下段梗阻的临床疗效。方法　分析2024年1月至2026年5月广东省中西医结合医院收治了20例特殊类型输尿管中下段梗阻患者的临床资料，对患者手术时间、术前和术后的血红蛋白、肾积水及随访情况进行分析。结果　所有患者均一期完成手术，手术时间为（75.5±16.4）分钟，术前与术后第一天血红蛋白对比，有一定差异（t=6.141，P＜0.05），术前与术后1个月患侧肾积液对比，肾积液明显改善（t=3.937，P＜0.05）。结论　经皮肾通道顺行输尿管软镜治疗特殊类型输尿管中下段梗阻具有微创、安全、有效、并发症少、术后恢复快等优点，值得临床推广应用。

Objective To evaluate the clinical efficacy of antegrade flexible ureteroscopy in treating special types of middle and lower ureteral obstruction. Methods From January 2024 to May 2026, clinical data of 20 patients with special types of middle and lower ureteral obstruction admitted to Guangdong Provincial Hospital of Integrated Traditional Chinese and Western Medicine were analyzed. The operation time, preoperative and postoperative hemoglobin levels, hydronephrosis, and follow-up conditions of the patients were analyzed. Results All patients underwent successful single-stage surgery, with an average operative time of (75.5 ± 16.4) minutes. There was a significant difference in hemoglobin levels between preoperatively and on the first postoperative day (t = 6.141, P < 0.05). Hydronephrosis on the affected side showed marked improvement when comparing preoperative and one-month postoperative conditions (t = 3.937, P < 0.05). Conclusions Antegrade flexible ureteroscopy via percutaneous nephrostomy tract is a minimally invasive, safe, effective, and well-tolerated approach for treating special types of middle and lower ureteral obstruction, with few complications and rapid postoperative recovery, making it worthy of clinical promotion and application.

目的 比较末端可弯曲负压吸引输尿管鞘（FANS-UAS）联合输尿管软镜与传统输尿管通路鞘（T-UAS）联合输尿管软镜治疗单侧上尿路结石的临床效果。方法 选取2023-05至2025-05我院120例单侧上尿路结石患者为研究对象，根据电脑随机法分为研究组、对照组，各60例。研究组采用FANS-UAS联合输尿管软镜治疗，对照组采用T-UAS联合输尿管软镜治疗。比较两组患者手术指标、结石清除效果、疼痛程度[视觉模拟量表（VAS）评分]、炎症反应[血清C反应蛋白（CRP）、白细胞介素-6（IL-6）、降钙素原（PCT）]及并发症情况。结果 研究组手术时间、碎石时间、术后下床活动时间、住院时间较对照组缩短，术中出血量较对照组降低，术后即刻、术后3d结石清除率较对照组显著升高（P＜0.05）；术后1d、3d研究组VAS评分较对照组降低（P＜0.05）；术后1d、3d研究组血清CRP、IL-6、PCT水平较对照组降低（P＜0.05）；两组并发症总发生率比较无显著差异（P＞0.05）。 结论 与T-UAS联合输尿管软镜相比，FANS-UAS联合输尿管软镜治疗单侧上尿路结石患者能优化流程，提升结石清除率，降低疼痛程度，减轻炎症反应，加快围术期恢复，安全性良好。

目的 比较末端可弯曲负压吸引输尿管鞘（FANS-UAS）联合输尿管软镜与传统输尿管通路鞘（T-UAS）联合输尿管软镜治疗单侧上尿路结石的临床效果。方法 选取2023-05至2025-05我院120例单侧上尿路结石患者为研究对象，根据电脑随机法分为研究组、对照组，各60例。研究组采用FANS-UAS联合输尿管软镜治疗，对照组采用T-UAS联合输尿管软镜治疗。比较两组患者手术指标、结石清除效果、疼痛程度[视觉模拟量表（VAS）评分]、炎症反应[血清C反应蛋白（CRP）、白细胞介素-6（IL-6）、降钙素原（PCT）]及并发症情况。结果 研究组手术时间、碎石时间、术后下床活动时间、住院时间较对照组缩短，术中出血量较对照组降低，术后即刻、术后3d结石清除率较对照组显著升高（P＜0.05）；术后1d、3d研究组VAS评分较对照组降低（P＜0.05）；术后1d、3d研究组血清CRP、IL-6、PCT水平较对照组降低（P＜0.05）；两组并发症总发生率比较无显著差异（P＞0.05）。 结论 与T-UAS联合输尿管软镜相比，FANS-UAS联合输尿管软镜治疗单侧上尿路结石患者能优化流程，提升结石清除率，降低疼痛程度，减轻炎症反应，加快围术期恢复，安全性良好。

目的 比较末端可弯曲负压吸引输尿管鞘（FANS-UAS）联合输尿管软镜与传统输尿管通路鞘（T-UAS）联合输尿管软镜治疗单侧上尿路结石的临床效果。方法 选取2023-05至2025-05我院120例单侧上尿路结石患者为研究对象，根据电脑随机法分为研究组、对照组，各60例。研究组采用FANS-UAS联合输尿管软镜治疗，对照组采用T-UAS联合输尿管软镜治疗。比较两组患者手术指标、结石清除效果、疼痛程度[视觉模拟量表（VAS）评分]、炎症反应[血清C反应蛋白（CRP）、白细胞介素-6（IL-6）、降钙素原（PCT）]及并发症情况。结果 研究组手术时间、碎石时间、术后下床活动时间、住院时间较对照组缩短，术中出血量较对照组降低，术后即刻、术后3d结石清除率较对照组显著升高（P＜0.05）；术后1d、3d研究组VAS评分较对照组降低（P＜0.05）；术后1d、3d研究组血清CRP、IL-6、PCT水平较对照组降低（P＜0.05）；两组并发症总发生率比较无显著差异（P＞0.05）。 结论 与T-UAS联合输尿管软镜相比，FANS-UAS联合输尿管软镜治疗单侧上尿路结石患者能优化流程，提升结石清除率，降低疼痛程度，减轻炎症反应，加快围术期恢复，安全性良好。

目的 探讨选择输尿管软镜下钬激光碎石术治疗肾结石（直径≤3 cm）的效果。方法 回顾性选择2021年1月—2023年1月广州市增城区新塘医院接收的180例肾结石（直径≤3 cm）患者为研究对象,按照手术方式分为对照组（n=90,给予经皮肾镜碎石术治疗）与观察组（n=90,给予输尿管软镜下钬激光碎石术治疗）,比较两组的结石清除效果、并发症、手术治疗情况、炎症反应、肾功能指标。结果 观察组结石清除89例、清除率98.89%,与对照组85例、清除率94.44%比较差异无统计学意义（χ²=2.758,P=0.096）;观察组发生并发症1例、发生率1.11%,比对照组8例、发生率8.89%更低（χ²=5.731,P=0.016）。与对照组（58.45±10.62）min、（32.26±4.49）mL、（10.42±2.27）g/L、（4.25±0.86）min比较,观察组手术操作时长（70.05±15.24）min更高,术中失血量（10.22±2.28）mL更少、术后血红蛋白（Hb）下降值（3.94±1.05）g/L更低,视觉模拟评分法（VAS）（2.22±0.42）分更低（t分别为5.924、41.521、24.579、20.121,P<0.05）。术后两组白细胞计数（WBC）、C-反应蛋白（CRP）、肿瘤坏死因子-α（TNF-α）、降钙素原（PCT）明显升高,而观察组（7.62±1.15）×10⁹/L、（14.25±2.24）mg/L、（1.65±0.34）mg/mL、（17.22±1.45）ng/ml明显低于对照组（8.82±1.41）×10⁹/L、（22.26±3.63）mg/L、（2.56±0.44）mg/mL、（20.64±2.87）ng/mL（t分别为6.256、17.814、15.525,10.090,P<0.05）。术后两组各指标明显升高,血肌酐（Scr）、胱抑素-C（Cys-C）、血尿素氮（BUN）组间比较差异无统计学意义（P>0.05）;而观察组、中性粒细胞明胶酶相关脂质运载蛋白（NGAL）（4.95±0.84）μg/L明显低于对照组（6.45±1.15）μg/L（t=9.992,P<0.05）。结论 输尿管软镜引导下置入钬激光进行碎石可有效治疗直径≤3 cm肾结石,取得与经皮肾镜相当的疗效,可进一步减轻疼痛,减少出血,控制炎症反应,避免肾功能损伤,安全性更高。

目的 对比输尿管硬镜、输尿管软镜钬激光碎石术在输尿管上段结石治疗中的应用价值。方法 分析于我院接受住院手术治疗的80例输尿管上段结石患者基本资料,按照入院顺序对患者进行分组治疗,对照组实施输尿管硬镜钬激光碎石术治疗,研究组实施输尿管软镜钬激光碎石术治疗,对比两组治疗相关数据及并发症发生率。结果 术后研究组患者PCT、CRP、IL-6、IL-10指标均较对照组理想（P<0.05）;术后研究组患者生活质量评分高于对照组（P<0.05）;研究组高热发生率低于对照组（P<0.05）,其他并发症发生率无明显差异（P>0.05）。结论 相比输尿管硬镜,对输尿管上段结石患者实施输尿管软镜钬激光碎石术治疗能够显著改善手术指标和炎性因子指标,有利于提升患者术后生活质量,且安全性良好。

Objective To explore the value of ureteral rigid and ureteral flexible holmium laser lithotripsy in the treatment of upper ureteral stones．Methods The basic data of 80 patients with upper ureteral stones who underwent inpatient surgical treatment in our hospital were analysed,and the patients were divided into equal groups according to the order of admission．The control group was treated with holmium laser lithotripsy by rigid ureteroscopy,and the study group was treated with holmium laser lithotripsy by ureteroscopy,and the treatment-related data and the incidence of complications were compared between the two groups．Results PCT,CRP,IL-6,and IL-10 indices were closer to the standard range in patients in the study group after surgery（P<0.05）;postoperative quality of life scores of the patients in the study group were higher compared with those in the control group（P<0.05）;the incidence of hyperthermia was lower in the study group than in the control group（P<0.05）,and there was no significant difference in the incidence of other complications（P>0.05）．Conclusions Holmium laser lithotripsy with flexible ureteroscopy for patients with upper ureteral stones can significantly improve surgical indexes and inflammatory factor indexes,and is conducive to the improvement of postoperative quality of life and safety,and has the value of popularization．