输尿管软镜钬激光碎石术治疗泌尿系结石的疗效分析  

Analysis of therapeutic effect of ureteroscopic holmium laser lithotripsy for urinary calculi

作　　者：张磊 ZHANG Lei(Department of Urology,The First People's Hospital of Bijie,Bijie 551700,China)

机构地区：[1]贵州省毕节市第一人民医院泌尿外科,551700

出　　处：《中国实用医药》2023年第18期35-39,共5页China Practical Medicine

摘　　要：目的探究输尿管软镜钬激光碎石术治疗泌尿系结石的疗效。方法50例泌尿系结石患者,使用随机数字表法分为观察组和对照组,每组25例。对照组采用单通道经皮肾镜取石术治疗,观察组采用输尿管软镜钬激光碎石术治疗。对比两组围术期指标、生活质量、炎性因子[降钙素原(PCT)、白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)、C反应蛋白(CRP)]、并发症发生情况、满意度。结果观察组术后下床时间(4.26±1.12)h、手术时间(90.25±24.56)min以及住院时间(4.13±0.85)d短于对照组的(6.12±1.15)h、(106.23±29.15)min、(5.04±0.97)d,术中出血量(3.12±0.45)ml少于对照组的(9.58±0.45)ml,差异具有统计学意义(P<0.05)。术后4个月,观察组生理功能、社会功能、角色功能、整体健康评分分别为(81.45±6.25)、(84.24±6.25)、(87.12±6.45)、(88.27±10.25)分,显著高于对照组的(76.23±5.24)、(78.65±6.35)、(77.84±6.23)、(79.56±9.84)分,差异具有统计学意义(P<0.05)。术后7 d,观察组PCT、IL-6、TNF-α、CRP水平分别为(0.40±0.05)ng/L、(4.35±1.85)mg/L、(0.28±0.07)ng/ml、(1.06±0.22)ng/ml,低于对照组的(0.48±0.07)ng/L、(9.65±1.78)mg/L、(0.41±0.13)ng/ml、(1.54±0.18)ng/ml,差异具有统计学意义(P<0.05)。观察组患者并发症发生率12.00%低于对照组的36.00%,差异具有统计学意义(P<0.05)。观察组患者总满意率88.00%高于对照组的64.00%,差异具有统计学意义(P<0.05)。结论采用输尿管软镜钬激光碎石术治疗泌尿系结石效果显著,可以有效缩短手术时间、住院时间,减少术中出血量,减轻患者机体炎症反应及术后并发症发生情况,提升患者满意度,值得临床推广应用。Objective To investigate the therapeutic effect of ureteroscopic holmium laser lithotripsy for urinary calculi.Methods A total of 50 patients with urinary calculi were divided into observation group and control group according to the random numerical table,with 25 cases in each group.The control group was treated with single-channel percutaneous nephrolithotomy,and the observation group was treated with ureteroscopic holmium laser lithotripsy.Both groups were compared in terms of perioperative indexes,quality of life,inflammatory factors[procalcitonin(PCT),interleukin-6(IL-6),tumor necrosis factor-α(TNF-α),C-reactive protein(CRP)],complications,and satisfaction.Results In the observation group,the postoperative ambulation time was(4.26±1.12)h,the operative time was(90.25±24.56)min and the hospitalization time was(4.13±0.85)d,which were shorter than those of(6.12±1.15)h,(106.23±29.15)min and(5.04±0.97)d in the control group;the intraoperative blood loss of(3.12±0.45)ml in the observation group was less than that of(9.58±0.45)ml in the control group;the differences were statistically significant(P<0.05).At 4 months postoperatively,the scores of physiological function,social function,role function and overall health of the observation group were(81.45±6.25),(84.24±6.25),(87.12±6.45)and(88.27±10.25)points,which were significantly higher than those of(76.23±5.24),(78.65±6.35),(77.84±6.23)and(79.56±9.84)points of the control group,and the differences were statistically significant(P<0.05).At 7 d postoperatively,the levels of PCT,IL-6,TNF-αand CRP in the observation group were(0.40±0.05)ng/L,(4.35±1.85)mg/L,(0.28±0.07)ng/ml and(1.06±0.22)ng/ml,which were lower than those of(0.48±0.07)ng/L,(9.65±1.78)mg/L,(0.41±0.13)ng/ml and(1.54±0.18)ng/ml in the control group,and the differences were statistically significant(P<0.05).The incidence of complications in the observation group was 12.00%,which was lower than that of 36.00%in the control group,and the difference was statistically significant(P<0.0

关 键 词：输尿管软镜 泌尿系结石 钬激光碎石术 疗效 

分 类 号：R699[医药卫生—泌尿科学]