探讨输尿管镜下钬激光碎石手术治疗输尿管结石的效果  

Exploring the Effect of Holmium Laser Lithotripsy under Ureteroscopy for Ureteral Stones

作　　者：国大宇 陈鑫[1] 菅天琦 GUO Dayu;CHEN Xin;JIAN Tianqi(Department of Urology,Chifeng Hospital,Chifeng,Inner Mongolia Autonomous Region,024000 China)

机构地区：[1]赤峰市医院泌尿外科,内蒙古赤峰024000

出　　处：《中外医疗》2023年第4期73-76,共4页China & Foreign Medical Treatment

摘　　要：目的分析输尿管结石疾病特点,评价输尿管镜下钬激光碎石手术治疗的临床优势。方法选取2019年12月—2020年8月赤峰市医院泌尿外科收治的120例输尿管结石患者为研究对象,依据患者入院先后顺序分为两组,各60例。观察组患者采取输尿管镜下钬激光碎石术式,对照组患者采取气压弹道碎石术式。比较两组输尿管结石患者经不同手术方法治疗后的手术情况,包括取石效果、术后并发症、围手术期指标、血肌酐、尿素氮水平等。结果观察组患者的一次性碎石率为98.33%、结石排净率为95.00%均明显高于对照组,差异有统计学意义(χ^(2)=8.106、7.212,P<0.05);观察组手术时间比对照组短,术中失血量比对照组少,下床活动时间比对照组早,胃肠功能恢复时间比对照组快,差异有统计学意义(P<0.05);术后观察组患者的血肌酐、尿素氮水平均低于对照组,差异有统计学意义(P<0.05);观察组并发症发生率为3.33%,低于对照组,差异有统计学意义(P<0.05)。结论输尿管镜下钬激光碎石取石效果更好、安全性高,有效改善了患者的肾功能,减少了手术损伤、缩短了术后恢复时间,是优选术式。Objective To analyze the characteristics of ureteral stone disease and evaluate the clinical advantages of Holmium laser lithotripsy surgery under ureteroscopy for the treatment of ureteral stones.Methods A total of 120 patients with ureteral calculi admitted to the urological department of Chifeng City Hospital from December 2019 to August 2020 were selected as the study subjects.They were divided into two groups according to the order of admission,with 60 patients in each group.Patients in the observation group underwent ureteroscopic holmium laser lithotripsy,while patients in the control group underwent pneumatic ballistic lithotripsy.The surgical outcomes of two groups of patients with ureteral calculi treated with different surgical methods were compared,including stone removal effect postoperative complications,perioperative indicators,blood creatinine,and urea nitrogen levels.Results The one-time stone removal rate of 98.33% and stone removal rate of 95.00% in the observation group were significantly higher than those in the control group,the difference was statistically significant(χ^(2)=8.106,7.212,P<0.05).The operation time in the observation group was shorter than that in the control group,the intraoperative blood loss was less than that in the control group,the time to get out of bed was earlier than that in the control group,and the recovery of gastrointestinal function recoverytime was faster than that in the control group,the difference was statistically significant(P<0.05).The serum creatinine and urea nitrogen level in the observation group were lower than those in the control group after surgery,the difference was statistically significant(P<0.05).The incidence of postoperative complications in the observation group(3.33%)was lower than that in the control group,the difference was statistically significant(P<0.05).Conclusion Holmium laser lithotripsy under ureteroscopy is more effective and safe,which effectively improves the renal function of patients,reduces surgical injury and shortens post

关 键 词：钬激光碎石手术 输尿管结石 取石效果 围术期指标 肾功能 气压弹道碎石 并发症 

分 类 号：R699.4[医药卫生—泌尿科学]