一次性输尿管软镜钬激光碎石术结合软镜鞘置入在治疗肾结石患者中的效果观察  

Effect observation of disposable flexible ureteroscopy and laser lithotripsy combined with flexible ureteroscope sheath implantation in the treatment of patients with renal calculi

作　　者：贾磊 郑亮[1] 杜永辉[1] 惠鹏宇[1] 张志刚[1] Jia Lei;Zheng Liang;Du Yonghui;Hui Pengyu;Zhang Zhigang(Department of Urology,the Second Affiliated Hospital of Xi′an Medical College,Xi′an 710038,China)

机构地区：[1]西安医学院第二附属医院泌尿外科,西安710038

出　　处：《国际外科学杂志》2024年第10期666-671,共6页International Journal of Surgery

摘　　要：目的观察一次性输尿管软镜钬激光碎石术结合软镜鞘置入在治疗肾结石患者中的效果。方法回顾性选取2021年2月—2024年1月西安医学院第二附属医院收治的采用一次性输尿管软镜钬激光碎石术结合软镜鞘置入治疗的60例肾结石患者为观察组,根据年龄(±5岁)、性别因素匹配,按照随机数字表法选取60例同一时间段采用一次性输尿管软镜裸镜联合钬激光碎石术治疗的肾结石患者为对照组。记录并比较两组患者的术中出血量、手术时间和住院时间。分别于术前及术后3 d,采用全自动生化分析仪检测血清肾功能参数尿素氮和肌酐水平,采用酶联免疫吸附试验测定患者血清中炎性因子C反应蛋白(CRP)和白细胞介素-6(IL-6)水平。记录并比较两组患者的并发症发生情况。计量资料以均数±标准差(±s)表示,组间比较采用独立样本t检验;计数资料以例数和百分比[例(%)]表示,组间比较采用χ^(2)检验。结果观察组患者的术中出血量、手术时间、住院时间[分别为(23.2±5.9)mL、(98.8±8.5)min、(4.2±1.0)d]均少于对照组[分别为(27.3±6.5)mL、(112.5±9.8)min、(4.7±1.3)d],差异均具有统计学意义(P<0.05)。观察组患者的清石成功率为100.00%(60/60),高于对照组(81.67%,49/60),差异具有统计学意义(χ^(2)=10.01,P=0.002)。术后3 d,观察组患者的血清尿素氮、肌酐、CRP、IL-6水平[分别为(7.04±1.24)mmol/L、(73.21±6.87)μmol/L、(15.83±2.57)mg/L、(10.52±1.02)ng/L]均低于对照组[分别为(7.63±1.32)mmol/L、(78.59±7.52)μmol/L、(21.32±3.22)mg/L、(15.47±1.35)ng/L],差异具有统计学意义(P<0.05)。观察组患者的术后并发症发生率(3.33%)低于对照组(13.33%),差异具有统计学意义(χ^(2)=3.93,P=0.048)。结论一次性输尿管软镜钬激光碎石术结合软镜鞘置入治疗肾结石患者可以提高对肾功能的保护作用,提高患者清石率,降低术后出血量和并发症发生率,缩短手术时间�ObjectiveTo observe the effect of disposable flexible ureteroscopy and laser lithotripsy combined with flexible ureteroscope sheath implantation in the treatment of patients with renal calculi.MethodsSixty patients with kidney calculi treated by disposable flexible ureteroscopy and laser lithotripsy combined with flexible ureteroscope sheath implantation in the Second Affiliated Hospital of Xi′an Medical College from February 2021 to January 2024 were retrospectively selected as the observation group,matched according to age(±5 years)and gender factors,according to the random number table method,60 patients with kidney calculi who were treated with disposable ureteroscopy combined with laser lithotripsy at the same time were selected as the control group.The amount of intraoperative blood loss,operation time and hospital stay were recorded and compared between the two groups.Serum renal function parameters urea nitrogen and creatinine levels were measured by automatic biochemical analyzer before and 3 days after surgery,and serum inflammatory factor C-reactive protein(CRP)and interleukin-6(IL-6)levels were measured by enzyme-linked immunosorbent assay(ELISA).The incidence of complications was recorded and compared between the two groups.Measurement data were expressed as mean±standard deviation(±s),and independent sample t-test was used for comparison between groups.The count data were expressed as the number of cases and percentage,and the Chi-square test was used for comparison between groups.ResultsThe intraoperative blood loss,operation time and hospital stay in the observation group[(23.2±5.9)mL,(98.8±8.5)min,(4.2±1.0)d,respectively]were all lower than those in the control group[(27.3±6.5)mL,(112.5±9.8)min,(4.7±1.3)d,respectively],the differences were statistically significant(P<0.05).The success rate of stone removal in the observation group was 100.00%(60/60),higher than that in the control group(81.67%,49/60),and the difference was statistically significant(χ^(2)=10.01,P=0.002).3 days after su

关 键 词：肾结石 钬 碎石术 激光 输尿管软镜 肾功能 

分 类 号：R699.2[医药卫生—泌尿科学]