微创输尿管软镜下钬激光碎石术治疗直径≥2 cm上尿路结石患者的效果  

Effect of minimally invasive ureteroscopic holmium laser lithotripsy in the treatment of patients with upper urinary tract calculi with diameter≥2 cm

作　　者：杨涛[1] YANG Tao(Department of Urology,Maternal and Child Health Hospital of Tengzhou City,Zaozhuang,Shandong,277500,China)

机构地区：[1]滕州市妇幼保健院泌尿外科,山东枣庄277500

出　　处：《当代医学》2023年第16期169-171,共3页Contemporary Medicine

摘　　要：目的探讨微创输尿管软镜下钬激光碎石术治疗直径≥2 cm上尿路结石患者的效果。方法选取2019年11月至2020年11月本院泌尿外科收治的拟行上尿路结石取石手术的69例患者作为研究对象,采用随机摸球法分为观察组(n=35)与对照组(n=34)。对照组行体外震波碎石术治疗,观察组行微创输尿管软镜下钬激光碎石术治疗,比较两组手术指标、巴氏指数(BI)及术后并发症发生情况。结果观察组结石清除率高于对照组,术中出血量少于对照组,手术时间长于对照组,差异有统计学意义(P<0.05)。术前,两组BI指数比较差异无统计学意义;术后,两组BI指数均高于术前,且观察组高于对照组,差异有统计学意义(P<0.05)。观察组并发症发生率为5.71%,低于对照组的26.47%,差异有统计学意义(P<0.05)。结论微创输尿管软镜下钬激光碎石术治疗直径≥2 cm上尿路结石安全有效,能提高患者结石清除率,缩短手术时间,减少术中出血量,降低术后并发症发生率,提高患者日常生活活动能力,值得临床推广应用。Objective To explore the effect of minimally invasive ureteroscopic holmium laser lithotripsy in the treatment of patients with upper urinary tract calculi with diameter≥2 cm.Methods A total of 69 patients who were admitted to the department of Urology of our hospital from November 2019 to November 2020 and planned to undergo upper urinary tract calculi removal surgery were selected as the study subjects,they were randomly divided into the observation group(n=35)and the control group(n=34)using touch ball method.The control group underwent extracorporeal shock wave lithotripsy,while the observation group underwent minimally invasive ureteroscopic holmium laser lithotripsy,the surgical indicators,Barthel index(BI),and postoperative complications were compared between the two groups.Results The stone clearance rate in the observation group was higher than that in the control group,the intraoperative blood loss was less than that in the control group,and the operation time was longer than that in the control group,the differences were statistically significant(P<0.05).Before operation,there was no significant difference in BI index between the two groups;after operation,the BI indexes of the two groups were higher than those before operation,and the observation group was higher than the control group,the difference was statistically significant(P<0.05).The incidence of complications in the observation group was 5.71%,which was lower than 26.47%in the control groups,the differences were statistically significant(P<0.05).Conclusion The minimally invasive ureteroscopic holmium laser lithotripsy is safe and effective in the treatment of upper urinary calculi with diameter≥2 cm,it can improve the stone clearance rate,shorten the operation time,reduce the intraoperative blood loss,reduce the incidence of postoperative complications,and improve the daily living ability of patients,which is worthy of clinical promotion and application.

关 键 词：微创 输尿管软镜 钬激光 尿路结石 碎石术 

分 类 号：R699.2[医药卫生—泌尿科学]