Abstract: Objective To compare the clinical effects of 3Fr ureteral catheter and zebra guidewire in guiding scope insertion duringureteroscopy. Methods A total of 161 patients who were scheduled to undergo ureteroscopy in the hospital from January 2022 to July 2025 were enrolled in this study. They were randomly divided into the 3Fr ureteral catheter group （n=81） and the zebra guidewire group （n=80） by the envelope method. The operation time of the two groups was compared, as well as the differences in C-reactive protein （CRP）, urine protein/creatinine ratio （UPCR） before and after the operation and the occurrence of complications. Results The operation time of the 3Fr ureteral catheter group was significantly longer than that of the zebra guidewire group （P< 0.05）. In all subgroups based on stone size （≤ 1.5 cm or > 1.5 cm） and stone location （upper or mid-lower segment）, the 3Fr catheter group also exhibited significantly longer operative times than the zebra guidewire group （P< 0.05）. Postoperatively, both groups showed elevated CRP and UPCR levels, with the 3Fr catheter group significantly higher than the zebra guidewire group, and this difference remained significant across all subgroups （P< 0.05）. The incidence of ureteral injury in the Fr ureteral catheter group was significantly lower than that in the Zebra guidewire group （4.94% vs. 15.00%）, while the incidence of stones returning to the kidney was significantly higher in the Fr ureteral catheter group than in the Zebra guidewire group （11.11% vs. 2.50%; P< 0.05）. The total incidence of complications between the two groups was not significantly different （P> 0.05）. Conclusion 3Fr ureteral catheter has more advantages in reducing ureteral mucosal injury, while zebra guidewire performs better in shortening operation time, reducing the risk of stone displacement, and alleviating postoperative stress response. It is recommended that the appropriate guidance method be chosen based on the patient′s condition and surgical requirements.

Key words: ureteroscope, 3Fr ureteral catheter, zebra guidewire, ureteral injury, stress response

摘要： 目的 对比研究输尿管镜术中使用3Fr输尿管导管与斑马导丝引导入镜的临床效果。方法 选取2022年1月至2025年7月期间我院收治的161例拟行输尿管镜术治疗的患者为研究对象,以信封法随机分为3Fr输尿管导管组（n=81）和斑马导丝组（n=80）。比较两组操作时间,以及手术前后C反应蛋白（CRP）、尿蛋白/肌酐比值（UPCR）的差异以及并发症发生情况。结果 3Fr输尿管导管组操作时间显著长于斑马导丝组（P<0.05）;在结石大小（≤1.5 cm或>1.5 cm）和结石位置（上段或中下段）各亚组中,3Fr导管组手术时间也均显著长于斑马导丝组（P<0.05）。术后两组CRP、UPCR均升高,3Fr输尿管导管组均显著高于斑马导丝组,且在各亚组中,3Fr导管组均显著高于斑马导丝组（P<0.05）。3Fr输尿管导管组输尿管损伤发生率显著低于斑马导丝组（4.94% vs. 15.00%;P<0.05）,结石返回肾内发生率显著高于斑马导丝组（11.11% vs. 2.50%,P<0.05）;两组并发症总发生率差异无统计学意义（P>0.05）。结论 3Fr输尿管导管在减少输尿管黏膜损伤方面更具优势,而斑马导丝在缩短手术时间、降低结石移位风险和减轻术后应激反应方面表现更佳,建议临床根据患者具体情况和手术需求合理选择引导方式。

关键词: 输尿管镜, 3Fr输尿管导管, 斑马导丝, 输尿管损伤, 应激反应