硕通镜钬激光碎石术治疗上尿路结石的效果观察  

Clinical effects of Shuotong ureteroscopic holmium laser lithotripsy on upper urinary calculi

作　　者：赵宇峰[1] 王晓华[1] 郭晓波[1] 牛卫星[1] Zhao Yufeng;Wang Xiaohua;Guo Xiaobo;Niu Weixing(Department of Urology,Affiliated Heji Hospital of Changzhi Medical College,Changzhi 046000,China)

机构地区：[1]长治医学院附属和济医院泌尿外科,山西长治046000

出　　处：《中国实用医刊》2020年第1期73-77,共5页Chinese Journal of Practical Medicine

摘　　要：目的 比较硕通镜钬激光碎石术与输尿管镜钬激光碎石术治疗上尿路结石的效果及安全性.方法 回顾性分析2017年6月至2019年5月于长治医学院附属和济医院接受碎石手术的97例上尿路结石患者的临床资料,按照手术方式分为硕通镜组43例与输尿管镜组54例,硕通镜组行硕通镜钬激光碎石术,输尿管镜组行输尿管镜钬激光碎石术,比较两组一次性置鞘成功率、手术时间、术后住院时间及术后1、30 d结石清除率,观察两组手术前后血红蛋白、血肌酐水平变化,记录并比较两组术中、术后并发症发生情况.结果 硕通镜组手术时间少于输尿管镜组(P<0.05),两组一次性置鞘成功率、术后住院时间比较差异未见统计学意义(P>0.05);硕通镜组术后1、30 d结石清除率分别为88.37%(38/43)、97.67%(42/43),高于输尿管镜组同时间点的68.52%(37/54)、83.33%(45/54),P<0.05;硕通镜组并发症总发生率为9.30%(4/43),低于输尿管镜组的25.93%(14/54),P<0.05;两组术后血红蛋白水平均低于术前(P<0.05);两组手术前后血肌酐比较差异未见统计学意义(P>0.05),且两组血红蛋白、血肌酐同时间点比较差异未见统计学意义(P>0.05).结论 硕通镜钬激光碎石术较传统输尿管镜钬激光碎石术治疗上尿路结石在缩短手术时间、提高结石清除率、减少并发症方面更具优势,且安全性好.Objective To compare the efficacy and safety of Shuotong ureteroscopic holmium laser lithotripsy and ureteroscopic holmium laser lithotripsy in the treatment of upper urinary calculi.Methods The clinical data from 97 patients with upper urinary calculi who underwent lithotripsy in the Affiliated Heji Hospital of Changzhi Medical College from June 2017 to May 2019 were retrospectively analyzed.According to surgical methods,all patients were divided into Shuotong ureteroscopy group(43 cases)and ureteroscopy group(54 cases).Patients in the Shuotong ureteroscopy group underwent shuotong ureteroscopic holmium laser lithotripsy,and patients in the ureteroscopy group underwent ureteroscopic holmium laser lithotripsy.The success rate of one-time sheathing,operative time,postoperative hospital stay and stone clearance rate on 1 and 30 d after operation were compared between the two groups.The changes of hemoglobin and serum creatinine of the two groups were observed before and after operation.The occurrence of complications during and after operation of the two groups were recorded.Results The operative time in Shuotong ureteroscopy group was significantly lower than that in ureteroscopy group(P<0.05).There was no significant difference in the success rate of one-time sheathing or postoperative hospital stay between the two groups(P>0.05).The stone clearance rates on 1 and 3 d after operation were 88.37%(38/43)and 97.67%(42/43)respectively in the Shuotong ureteroscopy group,which were significantly higher than the 68.52%(37/54)and 83.33%(45/54)in the ureteroscopy group(P<0.05).The total incidence of complications in the Shuotong ureteroscopy group(9.30%,4/43)was significantly lower than that in the ureteroscopy group(25.93%,14/54),P<0.05.The hemoglobin level in the two groups after operation was significantly lower than that before operation(P<0.05),and there was no significant change in serum creatinine in neither group(P>0.05).There were no significant differences in the hemoglobin or serum creatinine between the two gr

关 键 词：尿路结石 硕通镜钬激光碎石 输尿管镜碎石 结石清除率 并发症 

分 类 号：R699[医药卫生—泌尿科学]