输尿管镜下钬激光碎石术治疗对输尿管结石患者机体应激状况及并发症的影响分析  

Assessing the Implications of Holmium Laser Lithotripsy During Ureteroscopy on Stress Status and Complications in Individuals Suffering from Ureteral Calculi

作　　者：李伟 韩聪祥 林吓聪 LI Wei;HAN Congxiang;LIN Xiacong(DepartmentⅡof Urology,Zhangzhou Third Hospital,Zhangzhou 363005,Fujian,China)

机构地区：[1]漳州市第三医院泌尿二科,福建漳州363005

出　　处：《中外医疗》2024年第20期5-8,共4页China & Foreign Medical Treatment

摘　　要：目的探讨输尿管结石患者经输尿管镜下钬激光碎石(Holmium Laser Lithotripsy,HLL)处理对机体应激状况的影响以及安全性分析。方法简单随机选取2022年4月—2023年8月漳州市第三医院收治的100例输尿管结石患者为研究对象,采用不同手术方法分为对照组和观察组,各50例。对照组行输尿管镜下气压弹道碎石(Pneumatic Lithotripsy,PL)术处理,观察组行输尿管镜下HLL术处理,对比两组的结石清除情况、手术基础指标、机体应激状况与并发症发生情况。结果观察组一次性碎石率与彻底排石率均高于对照组,差异有统计学意义(P均<0.05)。观察组各手术基础指标均优于对照组,差异有统计学意义(P均<0.05)。术后1 d,观察组3项机体应激指标(皮质醇、促肾上腺皮质激素及肾上腺素)均低于对照组,差异有统计学意义(P均<0.05)。观察组出现并发症的患者占比(6.00%)少于对照组(20.00%),差异有统计学意义(χ^(2)=4.332,P=0.037)。结论输尿管镜下HLL术用于输尿管结石患者的治疗,结石清除效果较理想,安全性较高,并可减少术中出血,减轻机体应激状况,加快术后恢复。Objective To investigate the effect of Holmium laser lithotripsy(HLL)on the stress of ureteral calculus and its safety.Methods 100 patients with ureteral calculi treated in Zhangzhou Third Hospital from April 2022 to August 2023 were simple randomly selected as the study objects,they were divided into control group and observation group by different surgical methods,with 50 cases in each group.The control group was treated with ureteroscopic pneumatic lithotripsy(PL),and the observation group was treated with ureteroscopic HLL.The calculi clearance,surgical basic indexes,body stress and incidence of complications of the two groups were compared.Results The rate of one-time stone crushing and complete stone removal in the observation group were higher than those in the control group,and the differences were statistically significant(both P<0.05).The basic surgical indexes of the observation group were better than those of the control group,and the differences were statistically significant(all P<0.05).On the first day after surgery,the three stress indexes(cortisol,adrenocorticotropic hormone and adrenaline)in the observation group were lower than those in the control group,and the differences were statistically significant(all P<0.05).The proportion of complications in the observation group(6.00%)was lower than that in the control group(20.00%),and the difference was statistically significant(χ^(2)=4.332,P=0.037).Conclusion HLL under ureteroscope is effective and safe in the treatment of ureteral calculi,and can reduce intraoperative bleeding,relieve the stress of the body and speed up postoperative recovery.

关 键 词：输尿管结石 输尿管镜下钬激光碎石术 机体应激状况 并发症 

分 类 号：R699[医药卫生—泌尿科学]