输尿管软镜与硬镜下钬激光碎石术治疗复杂性输尿管上段结石患者的效果比较  

Comparison of effects of titanium laser lithotripsy under flexible ureteroscope and rigid ureteroscope in treatment of patients with complex upper ureteral calculi

作　　者：刘涛[1] 方晓 黄金明[1] LIU Tao;FANG Xiao;HUANG Jinming(Department of Urology of the First Affiliated Hospital of Nanyang Medical College,Nanyang 473000 Henan,China)

机构地区：[1]南阳医学高等专科学校第一附属泌尿外科,河南南阳473000

出　　处：《中国民康医学》2024年第14期137-139,共3页Medical Journal of Chinese People’s Health

摘　　要：目的:比较输尿管软镜与硬镜下钬激光碎石术治疗复杂性输尿管上段结石患者的效果。方法:回顾性分析2021年7月至2023年2月该院收治的188例复杂性输尿管上段结石患者的临床资料,根据手术方法不同将其分为软镜组(n=94)和硬镜组(n=94)。软镜组给予输尿管软镜下钬激光碎石术治疗,硬镜组予以输尿管硬镜下钬激光碎石术治疗。比较两组围术期指标水平,手术前后氧化应激指标[皮质醇(Cor)、肾上腺素(E)、去甲肾上腺素(NE)]水平,以及并发症发生率。结果:软镜组手术时间、住院时间均短于硬镜组,术中出血量少于硬镜组,碎石成功率高于硬镜组,结石上移率低于硬镜组,差异均有统计学意义(P<0.05);术后3 d,两组E、NE、Cor水平均高于术前,但软镜组低于硬镜组,差异有统计学意义(P<0.05);软镜组并发症发生率为4.26%(4/94),低于硬镜组的12.77%(12/94),差异有统计学意义(P<0.05)。结论:输尿管软镜下钬激光碎石术治疗复杂性输尿管上段结石患者可提高碎石成功率,改善围术期指标水平,减轻机体氧化应激反应,降低结石上移率和并发症发生率,效果优于输尿管硬镜下钬激光碎石术治疗。Objective:To compare effects of titanium laser lithotripsy under flexible ureteroscope and rigid ureteroscope in treatment of patients with complex upper ureteral calculi.Methods:The clinical data of 188 patients with complex upper ureteral calculi admitted to this hospital from July 2021 to February 2023 were retrospectively analyzed.According to the different surgical methods,they were divided into soft ureteroscope group(n=94)and rigid ureteroscope group(n=94).The flexible ureteroscope group was treated with Holmium laser lithotripsy under flexible ureteroscope,while the rigid ureteroscope group was treated with titanium laser lithotripsy under rigid ureteroscope.The levels of perioperative indexes and oxidative stress indexes[serum cortisol(Cor),epinephrine(E),norepinephrine(NE)]before and after the surgery,and the incidence of complications were compared between the two groups.Results:The operation time and the hospitalization time of the soft ureteroscope group were shorter than those of the rigid ureteroscope group,the intraoperative blood loss was less than that of the rigid ureteroscope group,the success rate of lithotripsy was higher than that of the rigid ureteroscope group,the stone migration rate was lower than that of the rigid ureteroscope group,and the differences were statistically significant(P<0.05).3 days after the surgery,the levels of E,NE and Cor in the two groups were higher than those before the treatment,those in the soft ureteroscope group were lower than those in the rigid ureteroscope group,and the differences were statistically significant(P<0.05).Further,the incidence of complications in the soft ureteroscope group was 4.26%(4/94),which was lower than 12.77%(12/94)in the rigid ureteroscope group,and the difference was statistically significant(P<0.05).Conclusions:Holmium laser lithotripsy under flexible ureteroscope in the treatment of the patients with complex upper ureteral calculi can improve the success rate of lithotripsy,improve the levels of perioperative indexes,reduce the b

关 键 词：输尿管软镜 输尿管硬镜 钬激光碎石术 复杂性输尿管上段结石 氧化应激 并发症 

分 类 号：R693.4[医药卫生—泌尿科学]