f-UHLL术和RLUL术治疗复杂性输尿管上段结石的效果对照研究  

A comparative study on effects of f-UHLL and RLUL in the treatment of complicated upper ureteral calculi

作　　者：王雄海 黄飞 覃家武 Wang Xiong-hai;Huang Fei;Qin Jia-wu(Department of Urology,Laibin People's Hospital,Laibin 546100,China)

机构地区：[1]来宾市人民医院泌尿外科,来宾546100

出　　处：《湖南师范大学学报（医学版）》2021年第1期33-36,共4页Journal of Hunan Normal University(Medical Sciences)

基　　金：来宾市科学研究与技术开发计划项目(173320)。

摘　　要：目的:探讨一体式输尿管软镜下钬激光碎石术(f-UHLL)治疗复杂性输尿管上段结石(UUC)疗效。方法:回顾性分析2018年1月~2020年1月间收治的65例复杂性UUC患者临床资料,所有患者均进行手术。根据不同术式分为观察组(f-UHLL,n=32)和对照组(后腹腔镜下输尿管切开取石术,RLUL,n=33)。比较两组治疗进程(手术时间、术后拔导尿管时间、住院时间),术前、术后3d评估患者近期恢复情况[血红蛋白(Hb)、疼痛模拟评分(VAS)、C反应蛋白(CRP)]、评估术后3d、术后1个月结石清除率,记录术后患者并发症发生率。结果:术后3d,观察组结石清除率低于对照组;术后1月,两组结石清除率对比差异无统计学意义;观察组手术时间、术后拔导尿管时间、住院时间均小于对照组;两组术后发热、输尿管黏膜下损伤、肉眼血尿及总发生率对比,差异均无统计学意义;术后3d,两组Hb与术前对比差异无统计学意义,两组CRP水平均高于术前,两组VAS评分均低于术前,观察组CRP、VAS评分变动幅度均大于对照组。结论:一体式f-UHLL治疗复杂性UUC疗效较好,且有利于改善患者围术期情况。Objective To explore the efficacy of integrated flexible-ureteroscopic holmium laser lithotripsy (f-UHLL) in the treatment of complicated upper ureteral calculi (UUC).Methods The clinical data of 65 patients with complicated UUC who were admitted between January 2018 and January 2020 were retrospectively analyzed,and all patients underwent surgery.According to different surgical procedures,they were divided into observation group (f-UHLL,n=32) and control group (retroperitoneal laparoscopic ureterolithotomy,RLUL,n=33).The treatment progress (surgery time,postoperative catheter extraction time,hospital stay) was compared between the two groups.The recent recovery [hemoglobin (Hb),visual analogue scale (VAS),C-reactive protein (CRP)]was evaluated before surgery and at 3d after surgery,and the stone clearance rate was evaluated at 3d after surgery and at 1 month after surgery.The incidence rates of postoperative complications were recorded.Results At 3d after surgery,the stone clearance rate in observation group was lower than that in control group.At 1 month after surgery,there was no significant difference in the stone clearance rate between the two groups.The surgery time,postoperative catheter extraction time and hospital stay in observation group were all lower than those in control group.There were no significant differences in the incidence rates of postoperative fever,ureteral submucosal injury and gross hematuria and total incidence rate between the two groups.At 3d after surgery,there was no significant difference in Hb in the two groups compared with that before surgery,and the CRP level in the two groups was higher than that before surgery while the VAS score in the two groups was lower than that before surgery,and the changes of CRP and VAS score in observation group were greater than those in control group.Conclusion Integrated f-UHLL has good efficacy in the treatment of complicated UUC,and it is beneficial to improve the perioperative condition of patients.

关 键 词：复杂性输尿管上段结石 一体式输尿管软镜 钬激光碎石 后腹腔镜下输尿管切开取石术 

分 类 号：R699[医药卫生—泌尿科学]