输尿管镜下钬激光碎石术与气压弹道碎石术治疗输尿管上段结石的临床效果观察  

Observation on the clinical effects of ureteroscopic holmium laser lithotripsy and pneumatic lithotripsy for patients with upper ureteral calculi

作　　者：莫俊华[1] 梁镇锋 罗道升[1] 米其武[1] MO Jun-hua;LIANG Zhen-feng;LUO Dao-sheng(Dongguan People’s Hospital,Dongguan 523018,China)

机构地区：[1]东莞市人民医院,523018

出　　处：《中国实用医药》2021年第23期20-23,共4页China Practical Medicine

摘　　要：目的比较针对输尿管上段结石患者予以输尿管镜下钬激光碎石术以及气压弹道碎石术治疗的临床效果。方法输尿管上段结石患者330例,按碎石方式不同分为激光组(180例)和弹道组(150例)。弹道组予以输尿管镜下气压弹道碎石术治疗,激光组予以输尿管镜下钬激光碎石术治疗。比较两组患者手术效果、手术指标、治疗前后肾功能以及并发症发生情况。结果激光组一次碎石成功率95.00%高于弹道组的86.67%,结石排净率92.78%高于弹道组的83.33%,二次手术率7.22%低于弹道组的16.67%,差异均具有统计学意义(P<0.05);两组住院费用比较,差异无统计学意义(P>0.05)。激光组手术时间(60.03±8.65)min长于弹道组的(47.65±7.38)min,差异具有统计学意义(P<0.05)。两组术中出血量、住院时间比较,差异均无统计学意义(P>0.05)。激光组患者治疗前血清肌酐为(246.45±64.47)μmol/L、尿素氮为(9.46±2.26)mmol/L,治疗后血清肌酐为(98.65±41.48)μmol/L、尿素氮为(7.08±1.17)mmol/L,弹道组患者治疗前血清肌酐为(245.56±65.27)μmol/L、尿素氮为(9.15±2.13)mmol/L,治疗后血清肌酐为(103.56±44.38)μmol/L、尿素氮为(6.84±1.08)mmol/L。治疗后,两组患者血清肌酐、尿素氮均低于治疗前,差异均具有统计学意义(P<0.05),但组间比较,差异无统计学意义(P>0.05)。激光组并发症发生率14.44%与弹道组的16.00%比较,差异无统计学意义(P>0.05)。结论针对输尿管上段结石予以输尿管镜下钬激光碎石术治疗,效果明显。Objective To compare the clinical effects of ureteroscopic holmium laser lithotripsy and pneumatic lithotripsy for patients with upper ureteral calculi.Methods A total of 330 patients with upper ureteral calculi were divided into laser group(180 cases)and pneumatic group(150 cases)according to different lithotripsy methods.The pneumatic group was treated with ureteroscopic holmium laser lithotripsy,and the laser group was treated with ureteroscopic pneumatic lithotripsy.The surgical effect,surgical indicators,renal function before and after treatment,and occurrence of complications were compared between the two groups.Results The one-time success rate of lithotripsy 95.00%of the laser group was higher than 86.67%of pneumatic group,calculi clearance rate 92.78%was higher than 83.33%of the pneumatic group,and reoperation rate 7.22%was lower than 16.67%of the pneumatic group.All the difference was statistically significant(P<0.05).There was no statistically significant difference in hospitalization costs between the two groups(P>0.05).The operation time(60.03±8.65)min of the laser group was longer than(47.65±7.38)min of the pneumatic group,and the difference was statistically significant(P<0.05).There was no statistically significant difference in intraoperative blood loss and hospitalization time between the two groups(P>0.05).In laser group,the serum creatinine and urea nitrogen were(246.45±64.47)μmol/L and(9.46±2.26)mmol/L before treatment,and(98.65±41.48)μmol/L and(7.08±1.17)mmol/L after treatment;in pneumatic group,the serum creatinine and urea nitrogen were(245.56±65.27)μmol/L and(9.15±2.13)mmol/L before treatment,and(103.56±44.38)μmol/L and(6.84±1.08)mmol/L after treatment.After treatment,the serum creatinine and urea nitrogen of the two groups were lower than those before treatment,and the difference was statistically significant(P<0.05),but the difference was not statistically significant between the two groups(P>0.05).The incidence of complications 14.44%of the laser group had no statisticall

关 键 词：输尿管上段结石 输尿管镜下 钬激光碎石术 气压弹道碎石术 

分 类 号：R699.4[医药卫生—泌尿科学]