The Second Affiliated Hospital of Nanjing Medical University
目的 对比本中心术前使用不同剂量间苯三酚对输尿管软镜钬激光碎石取石术（Retrograde intrarenal surgery，RIRS)的有效性及安全性；方法 本研究共纳入患者329例，根据术前间苯三酚使用情况分为治疗组177例[普通剂量组（80-120mg）67例和高剂量组（160-200mg）110例]和对照组152例，所有输尿管软镜通道鞘(Ureteral access sheath, UAS)置入成功患者再根据术前间苯三酚使用情况分为UAS置入成功治疗组170例[UAS置入成功普通剂量组（80-120mg）64例和UAS置入成功高剂量组（160-200mg）106例]和UAS置入成功对照组130例。对各组患者的基本信息、输尿管软镜通道鞘置入成功率、术后结石清除率、手术并发症发生率、术后止痛药物使用次数、手术时间、住院时间及药物副作用进行统计学分析；结果 对照组和治疗组的输尿管软镜通道鞘置入成功率分别是85.50%、96.00%，差异有统计学意义（P＜0.05）；UAS置入成功对照组和治疗组的一期清除率分别是39.23%、82.94%；一月清除率分别是59.23%、92.35%；平均术后止痛药物使用次数分别是5.51±1.43次、3.70±1.36次；平均手术时间分别是103.79±39.37分钟、70.14±26.31分钟，差异有统计学意义（P＜0.05）；UAS置入成功普通剂量组与高剂量组的一期清除率分别是70.31%、90.57%；一月清除率分别是85.94%、96.23%；平均术后止痛药物使用次数分别是4.13±1.56次、3.44±1.17次；平均手术时间分别是75.78±21.71分钟、66.74±28.29分钟；平均住院时间分别是4.09±2.47天、3.04±1.75天，差异有统计学意义（P＜0.05）；结论 术前静滴间苯三酚对RIRS是安全有效的，能显著提高输尿管软镜通道鞘置入成功率、一期清除率、一月清除率，且减轻术后疼痛、缩短手术时间。此外，相较常规剂量，高剂量的间苯三酚的有效性更高。
Objective：To compare the efficacy and safety of different doses of preoperative phloroglucinol in retrograde intrarenal surgery (RIRS) in our center; Methods：A total of 329 patients in this study were divided into two groups based on the preoperative use of different doses of phloroglucinol, 177 cases in the treatment group [67 cases in the normal dose group (80-120mg) and 110 cases in the high dose group (160-200mg)] and 152 cases in the control group. Furthermore, All patients with the success rate of UAS insertion based on the preoperative use of different doses of phloroglucinol, 170 cases were included into the treatment group [64 cases in the normal dose group (80-120mg) and 106 cases in the high dose group (160-200mg)] while 130 cases were included into the control group. The baseline information of patients, the success rate of UAS insertion, the stone-free rate, complication rate, the frequencies of postoperative analgesic drugs, operation time, hospital stays and side effects were collected and analyzed; Results：The success rate of UAS insertion in control and treatment group was 85.50% and 96.00%, which were significantly different (P < 0.05).In the control group and treatment group of the successful UAS insertion，the first-stage stone-free rates were 39.23% and 82.94%. Stone-free rates in first month were 59.23% and 92.35%, the average frequencies of postoperative analgesic drugs were 5.51 ± 1.43 times and 3.70 ± 1.36 times，the average operative time were 103.79 ±39.37 minutes and 70.14± 26.31minutes, which all were significantly different (P < 0.05); In the normal dose group and high dose group of the successful UAS insertion, the first-stage stone-free rates were 70.31% and 90.57%,Stone-free rates in first month were 85.94% and 96.23%，the average frequencies of postoperative analgesic drugs were 4.13 ± 1.56 times and 3.44 ± 1.17 times, the average operative time were 75.78 ± 21.71 minutes and 66.74 ± 28.29 minutes, the average hospital stays were 4.09 ± 2.47 days and 3.04 ±1.75 days, which were also significantly different (P < 0.05)；Conclusion：Preoperative intravenous infusion of phloroglucinol is safe and effective for RIRS, improving the success rate of UAS insertion, the first-stage and one-month stone-free rate as well as reducing postoperative pain and operative time; In addition, higher doses of phloroglucinol are more effective than normal doses.