钬激光碎石术治疗输尿管上段嵌顿结石患者感染的分析  

Efficacy and safety of holmium laser lithotripsy for treatment of infections in patients with upper ureteral calculi

作　　者：章庆华[1] 林谦[1] 宋正尧[1] 陈帆[1] 胡卫国[1] 

机构地区：[1]台州市第一人民医院泌尿外科,浙江台州318020

出　　处：《中华医院感染学杂志》2016年第12期2814-2816,共3页Chinese Journal of Nosocomiology

基　　金：浙江省卫计委基金资助项目(2013KYB132)

摘　　要：目的探讨钬激光碎石术治疗输尿管上段嵌顿结石合并感染患者的疗效及安全性,为临床治疗提供参考依据。方法选取2007年1月-2015年4月医院收治的输尿管上段嵌顿结石患者200例,将其随机分为对照组和观察组,每组各100例,两组患者术前均给予抗感染治疗;对照组采用输尿管镜气压弹道碎石术,观察组采用输尿管镜钬激光碎石术,观察患者治疗后碎石成功率、结石排净率,手术时间与住院天数、术后并发症及术后血像等指标。结果观察组患者碎石成功率及术后感染率为98.00%及5.00%,显著高于对照组的94.00%及8.00%,观察组患者治疗后2周及4周结石排净率也均高于对照组患者,差异均有统计学意义(P<0.05);观察组患者手术时间、住院天数短于对照组患者,术后血红蛋白水平较对照组有所升高,差异均有统计学意义(P<0.05);观察组患者术后并发症发生率均低于对照组患者,差异有统计学意义(P<0.05);观察组患者术后中性粒细胞绝对值以及白细胞总数均低于对照组,差异有统计学意义(P<0.05)。结论输尿管镜钬激光碎石术治疗输尿管上段嵌顿结石合并感染具有临床疗效显著,并发症少的特点,值得临床推广及应用。OBJECTIVE To investigate the efficacy and safety of holmium laser lithotripsy in the treatment of infection in patients with upper ureteral calculi so as to provide reference for clinical treatment.METHODS Totally200 patients with upper ureteral calculi treated during Jan.2007 to Apr.2015 were selected and randomly assigned to the control group and the observation group,100 patients in each group.Both groups of patients were given preoperative anti-infection treatment.Then ureteroscopic pneumatic ballistic lithotripsy was used in the control group,while holmium laser lithotripsy was used in the observation group.Patients were observed for success rate of lithotripsy,stone clearance rate,operation time,hospitalization time,postoperative complications and postoperative blood indicators.RESULTS The success rate and the infection rate of the observation group（98.00%,5.00%）were significantly higher than that of the control group（94.00%,8.00%）.The stone clearance rate was significantly higher in the observation group than in the control group at 2and 4weeks（P〈0.05）.The operation time and hospitalization time were shorter in the observation group than in the control group and the postoperative hemoglobin was elevated compared to the control group,with statistical significance（P〈0.05）.The incidence of postoperative complications was significantly lower in the observation than in the control group（P〈0.05）.The absolute neutrophil count and the total WBC were significantly lower in the observation group than in the control group（P〈0.05）.CONCLUSIONThe treatment of ureteral calculi with holmium laser lithotripsy has a significant clinical effect,and has the characteristics of few complications.It is worthy of clinical popularization and application.

关 键 词：输尿管结石 嵌顿 输尿管镜 钬激光碎石术 临床疗效 

分 类 号：R693.4[医药卫生—泌尿科学]