输尿管硬镜联合输尿管软镜钬激光碎石术治疗复杂性输尿管上段结石的效果分析  

Effect of Rigid and Flexible Ureteroscopic Holmium Laser Lithotripsy in Treatment of Complex Upper Ureteral Calculi

作　　者：郑鹏 Zheng Peng(Department of Urology Surgery,Tongji Chibi Hospital,Chibi437300,Hubei Province,China)

机构地区：[1]同济赤壁医院泌尿外科,湖北赤壁437300

出　　处：《中国社区医师》2024年第14期31-33,共3页Chinese Community Doctors

摘　　要：目的:分析输尿管硬镜联合输尿管软镜钬激光碎石术治疗复杂性输尿管上段结石的效果。方法:选取2020年3月—2022年12月同济赤壁医院收治的70例复杂性输尿管上段结石患者作研究对象,采用随机数字表法分为对照组与观察组,各35例。对照组实施输尿管硬镜钬激光碎石术,观察组在对照组基础上联合输尿管软镜钬激光碎石术。比较两组围术期指标、炎性指标、并发症发生情况。结果:观察组手术时间长于对照组,碎石时间短于对照组,术中出血量少于对照组,下床活动时间早于对照组,差异有统计学意义(P<0.001)。术前,两组白细胞计数(WBC)、中性粒细胞计数(NE)、血清降钙素原(PCT)水平比较,差异无统计学意义(P>0.05);术后7 d,两组WBC、NE、PCT水平高于术前,但观察组低于对照组,差异有统计学意义(P<0.05)。观察组并发症总发生率低于对照组,差异有统计学意义(P=0.022)。结论:输尿管硬镜联合输尿管软镜钬激光碎石术治疗复杂性输尿管上段结石的效果显著,可缩短碎石时间,减少术中出血量,减轻炎性反应,促进患者术后恢复,减少术后并发症。Objective:To analyze the effect of rigid and flexible ureteroscopic holmium laser lithotripsy in treatment of complex upper ureteral calculi.Methods:A total of 70 patients with complex upper ureteral calculi treated in Tongji Chibi Hospital from March 2020 to December 2022 were selected as the study subjects.They were divided into the control group and the observation group according to random number table method with 35 cases in each group.The control group was treated with rigid ureteroscopic holmium laser lithotripsy.The observation group was treated with flexible ureteroscopic holmium laser lithotripsy on the basis of control group.The perioperative indexes,inflammatory indexes and complications were compared between the two groups.Results:The operation time in the observation group was longer than that in the control group,the lithotripsy time in the observation group was shorter than that in the control group,the intraoperative blood loss in the observation group was less than that in the control group,the ambulation time in the observation group was earlier than that in the control group,and the difference was statistically significant(P<0.001).Before operation,there was no significant difference in the levels of white blood cell count(WBC),neutrophil count(NE)and serum procalcitonin(PCT)between the two groups(P>0.05).On 7 d after operation,the levels of WBC,NE and PCT in the two groups were higher than those before operation,but the levels in the observation group were lower than those in the control group,and the difference was statistically significant(P<0.05).The total incidence of complications in the observation group was lower than that in the control group,and the difference was statistically significant(P=0.022).Conclusion:The combination of rigid and flexible ureteroscopic holmium laser lithotripsy has a significant effect in the treatment of complex upper ureteral calculi,and can shorten the lithotripsy time,reduce the intraoperative blood loss,relieve inflammatory reaction,promote postoperative

关 键 词：复杂性输尿管上段结石 钬激光碎石术 输尿管硬镜 输尿管软镜 

分 类 号：R693.4[医药卫生—泌尿科学]