体外冲击波与输尿管镜钬激光碎石术治疗输尿管中上段结石的效果研究  

Study on the Effect of Extracorporeal Shock Wave and Ureteroscopic Hol⁃mium Laser Lithotripsy in the Treatment of Middle and Upper Ureteral Calculi

作　　者：薛建刚 马昊杰 薛刚 XUE Jiangang;MA Haojie;XUE Gang(Department of Urology,Qingdao Huangdao District Central Hospital,Qingdao,Shandong,266555,China;Emer-gency department,Qingdao Huangdao District Central Hospital,Qingdao,Shandong,266555,China)

机构地区：[1]青岛市黄岛区中心医院泌尿外科,山东青岛266555 [2]青岛市黄岛区中心医院急诊科,山东青岛266555

出　　处：《中外医疗》2024年第30期46-49,53,共5页China & Foreign Medical Treatment

摘　　要：目的 分析输尿管中上段结石给予输尿管镜钬激光碎石术和体外冲击波碎石治疗对于患者的影响。方法 方便选取2022年7月—2023年10月青岛市黄岛区中心医院收治的94例输尿管中上段结石患者为研究对象,根据不同治疗方法分组,各47例,对照组开展体外冲击波碎石术治疗,观察组开展输尿管镜钬激光碎石术治疗。比较两组患者的手术指标、术后并发症,治疗前后肾功能指标、肾积水程度以及炎症因子水平。结果 观察组一次性结石清除率为97.87%(46/47),高于对照组的82.98%(39/47),结石上移率为6.38%(3/47),低于对照组的25.53%(12/47),差异有统计学意义(χ^(2)=4.423、6.425,P均<0.05)。观察组住院时间短于对照组,差异有统计学意义(P<0.05)。两组手术时间比较,差异无统计学意义(P>0.05)。两组并发症发生率比较,差异无统计学意义(P>0.05)。治疗前,两组的肾功能指标、肾积水程度及炎症因子水平相比,差异无统计学意义(P均>0.05);治疗后,观察组的肾功能指标、肾积水程度及炎症因子水平均优于对照组,差异有统计学意义(P均<0.05)。结论 输尿管镜钬激光碎石术疗法用于输尿管中上段结石的治疗中,能有效清除结石,并预防结石上移,改善患者肾积水和肾功能,可以降低术后并发症,纠正炎症反应。Objective To analyze the effect of ureteroscopic holmium laser lithotripsy and extracorporeal shock wave lithotripsy on patients with middle and upper ureteral calculi.Methods 94 patients with middle and upper ureteral cal⁃culi admitted to Qingdao Huangdao District Central Hospital from July 2022 to October 2023 were conveniently se⁃lected as the research objects.They were divided into groups according to different treatment methods,47 cases in each group.The control group was treated with extracorporeal shock wave lithotripsy,and the observation group was treated with ureteroscopic holmium laser lithotripsy.The surgical indexes,postoperative complications,renal function indexes,degree of hydronephrosis and levels of inflammatory factors before and after treatment were compared be⁃tween the two groups.Results The one-time stone clearance rate of the observation group was 97.87%(46/47),which was higher than 82.98%(39/47)of the control group,and the stone migration rate was 6.38%(3/47),which was lower than 25.53%(12/47)of the control group,the differences were statistically significant(χ^(2)=4.423,6.425,both P<0.05).The hospitalization time of the observation group was shorter than that of the control group,and the difference was sta⁃tistically significant(P<0.05).There was no significant difference in the operation time between the two groups(P>0.05).There was no significant difference in the incidence of complications between the two groups(P>0.05).Before treatment,there was no significant difference in renal function index,degree of hydronephrosis and level of inflamma⁃tory factors between the two groups(all P>0.05).After treatment,the renal function index,degree of hydronephrosis and level of inflammatory factors in the observation group were better than those in the control group,and the differ⁃ences were statistically significant(all P<0.05).Conclusion Ureteroscopic holmium laser lithotripsy is used in the treatment of middle and upper ureteral calculi.It can effectively remove stones and prevent

关 键 词：输尿管中上段结石 体外冲击波 输尿管镜钬激光碎石术 并发症 肾功能 

分 类 号：R69[医药卫生—泌尿科学]