二期电子输尿管软镜激光碎石术治疗输尿管上段结石及肾结石的效果  

Treatment Effect of Upper Ureteral Calculi and Renal Calculi by Electronic Ureteroscopic Laser Lithotripsy with Second Stage

作　　者：程文宁 王振运 魏明权 郑建龙 吴金平 景琼 刘燕南 CHENG Wenning;WANG Zhenyun;WEI Mingquan;ZHENG Jianlong;WU Jinping;JING Qiong;LIU Yannan(Qingyang People's Hospital,Qingyang 745000,China;不详)

机构地区：[1]庆阳市人民医院,甘肃庆阳745000

出　　处：《中外医学研究》2024年第25期10-14,共5页CHINESE AND FOREIGN MEDICAL RESEARCH

摘　　要：目的:分析二期电子输尿管软镜激光碎石术治疗输尿管上段结石及肾结石的效果。方法:选取2021年1月—2023年6月庆阳市人民医院需采取二期手术治疗的200例输尿管上段结石及肾结石患者为研究对象。依据数字排列法将患者分为观察组和对照组,各100例。对照组采用经皮肾镜碎石激光碎石术,观察组采用电子输尿管软镜激光碎石术。比较两组结石治疗效果、手术相关指标、肾功能指标、炎症指标、术后并发症。结果:两组术后3 d、7 d结石清除率、再次手术率比较,差异无统计学意义(P>0.05)。观察组术中失血量、术后24 h视觉模拟评分法(visual analogue scale,VAS)评分低于对照组,手术时间长于对照组,差异有统计学意义(P<0.05)。观察组术后24 h血尿素氮(blood urea nitrogen,BUN)、血肌酐(serum creatinine,Scr)、β_(2)-微球蛋白(β_(2)-microglobulin,β_(2)-MG)低于对照组,差异有统计学意义(P<0.05)。观察组术后24 h白细胞介素-6(interleukin-6,IL-6)、降钙素原(procalcitonin,PCT)、肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)、C反应蛋白(C-reactive protein,CRP)低于对照组,差异有统计学意义(P<0.05)。观察组并发症发生率低于对照组,差异有统计学意义(P<0.05)。结论:二期经皮肾镜激光碎石术与电子输尿管软镜激光碎石术治疗输尿管上段结石及肾结石效果均较好,后者具有更好的手术安全性,术中失血量少,术后VAS评分低,且对肾功能、炎症指标影响小,有助于减少手术损伤。Objective:To analyze the treatment effect of upper ureteral calculi and renal calculi by electronic ureteroscopic laser lithotripsy with second stage.Method:A total of 200 patients with upper ureteral calculi and renal calculi who needed to undergo second stage surgical treatment in Qingyang People's Hospital from January 2021 to June 2023 were selected as the subjects.The patients were divided into observation group and control group by numerical arrangement,with 100 cases in each group.The control group was treated with percutaneous nephrolithotripsy laser lithotripsy,and the observation group was treated with electronic ureteroscope laser lithotripsy.The calculi treatment effect,operation related indexes,renal function indexes,inflammation indexes and postoperative complications were compared between the two groups.Result:There were no significant differences in stone clearance at 3 d and 7 d after operation and reoperation rate between the two groups(P>0.05).The operative blood loss and 24 h visual analogue scale(VAS)score of the observation group were lower than those of the control group,and the operative time was longer than that of the control group,the differences were statistically significant(P<0.05).The blood urea nitrogen(BUN),serum creatinine(Scr),β_(2)-microglobulin(β_(2)-MG)in the observation group were lower than those in the control group at 24 h after operation,and the differences were statistically significant(P<0.05).The interleukin-6(IL-6),procalcitonin(PCT),tumor necrosis factor-α(TNF-α),C-reactive protein(CRP)in the observation group were lower than those in the control group at 24 h after operation,and the differences were statistically significant(P<0.05).The incidence of complications in the observation group was lower than that in the control group,the difference was statistically significant(P<0.05).Conclusion:Second stage percutaneous nephrolithotripsy laser lithotripsy and electronic ureteroscope laser lithotripsy have better efficacy in the treatment of upper ureteral calculi a

关 键 词：输尿管上段结石 肾结石 二期手术 电子输尿管软镜 激光碎石术 肾功能 

分 类 号：R699[医药卫生—泌尿科学]