钬激光碎石与气压弹道碎石术对复杂输尿管上段结石患者氧化应激及远期的影响  

Effect of Holmium Laser Lithotripsy and Pneumatic Lithotripsy on Oxidative Stress and Long-term in Patients with Complicated Upper Ureteral Calculi

作　　者：韩超[1] 刘肇华[1] 陈敏坚[1] 杨志坚[1] 庞程[1] 吴炳权[1] HAN Chao;LIU Zhaohua;CHEN Minjian;YANG Zhijian;PANG Cheng;WU Bingquan(The First People’s Hospital of Zhaoqing City,Zhaoqing 526000,China)

机构地区：[1]广东省肇庆市第一人民医院,广东肇庆526000

出　　处：《中国医学创新》2020年第8期72-76,共5页Medical Innovation of China

摘　　要：目的:探讨钬激光碎石与气压弹道碎石术对复杂输尿管上段结石患者氧化应激及远期的影响。方法:选取2017年2月-2018年1月本院收治的96例复杂输尿管上段结石患者,按手术方法不同分成观察组和对照组,各48例。对照组行气压弹道碎石术,观察组行钬激光碎石。比较两组患者的氧化应激水平、近期疗效、并发症发生情况及远期复发率。结果:观察组患者手术时间及住院时间均较对照组明显缩短(P<0.05),且术中出血量明显少于对照组(P<0.05);观察组的总有效率为95.83%,明显高于对照组83.33%(P<0.05);术后1 d,两组SOD、MDA均较治疗前显著增高(P<0.05),CAT、GSH-Px均较治疗前显著降低(P<0.05),但观察组患者各氧化应激指标改变幅度均明显小于对照组(P<0.05);观察组术后复发率为6.25%,低于对照组的16.67%,差异有统计学意义(χ^2=4.315,P=0.042);两组术后并发症发生率比较,差异无统计学意义(P>0.05)。结论:钬激光碎石术较气压弹道碎石术治疗复杂输尿管上段结石能获得更佳的近期临床效果,降低远期复发率,值得扩大样本量深入研究。Objective:To investigate the effects of holmium laser lithotripsy and pneumatic lithotripsy on oxidative stress and long-term in patients with complicated upper ureteral calculi.Method:A total of 96 patients with complicated upper ureteral calculi admitted to our hospital from February 2017 to January 2018 were selected,patients were divided into the observation group andcontrol group,according to different surgical methods,48 cases in each group.The control group underwent pneumatic lithotripsy,the observation group underwent holmium laser lithotripsy.The oxidative stress level,short-term efficacy,complications and long-term recurrence rate of the two groups were compared.Result:The operation time and hospitalization time of the observation group were significantly shorter than those of the control group(P<0.05),and the intraoperative blood loss was significantly less than that of the control group(P<0.05).The total effective rate was 95.83%,which was significantly higher than 83.33%of the control group(P<0.05).The SOD and MDA of the two groups were significantly higher than those before treatment(P<0.05),and CAT and GSH-Px were significantly lower than those before treatment(P<0.05),but the change of oxidative stress index in the observation group were significantly lower than those in the control group(P<0.05).The postoperative recurrence rate in the observation group was 6.25%,lower than 16.67%in the control group,the difference was statistically significant(χ^2=4.315,P=0.042).There was no significant difference in the incidence of postoperative complications between the two groups(P>0.05).Conclusion:Holmium laser lithotripsy can achieve better short-term clinical efficacy and lower long-term recurrence rate than pneumatic lithotripsy in the treatment of complex upper ureteral calculi,it is worth to expand the sample size in-depth study.

关 键 词：钬激光碎石 气压弹道碎石术 输尿管镜 输尿管上段结石 氧化应激 

分 类 号：R699[医药卫生—泌尿科学]