输尿管软镜钬激光碎石术与经皮肾镜取石术治疗嵌顿性输尿管结石患者的效果比较  

Comparison of effects of flexible ureteroscopic holmium laser lithotripsy and percutaneous nephrolithotomy in the treatment of patients with impacted ureteral calculus

作　　者：蔡卫华 CAI Weihua(Department of Urology of Xiapu County Hospital,Ningde 355100 Fujian,China)

机构地区：[1]霞浦县医院泌尿外科,福建宁德355100

出　　处：《中国民康医学》2024年第22期126-129,共4页Medical Journal of Chinese People’s Health

摘　　要：目的:比较输尿管软镜钬激光碎石术与经皮肾镜取石术治疗嵌顿性输尿管结石患者的效果。方法:选取2020年10月至2023年10月该院收治的62例嵌顿性输尿管结石患者进行前瞻性研究,按随机数字表法将其分为对照组与研究组各31例。研究组采用输尿管软镜钬激光碎石术治疗,对照组采用经皮肾镜取石术治疗。比较两组手术相关指标(首次下床活动时间、手术时间、住院时间、术中出血量、一次性结石清除率)水平,手术前后炎性指标[白细胞计数(WBC)、C反应蛋白(CRP)、白细胞介素-6(IL-6)、降钙素原(PCT)]、肾功能指标[血肌酐(Scr)、胱抑素C(CysC)]水平,以及术后并发症发生率。结果:研究组首次下床活动时间、手术时间、住院时间均短于对照组,术中出血量少于对照组,一次性结石清除率高于对照组,差异有统计学意义(P<0.05);术后1 d,两组CRP、PCT、IL-6、WBC水平均高于术前,但研究组低于对照组,差异有统计学意义(P<0.05);术后3 d,两组Scr、CysC水平均低于术前,且研究组低于对照组,差异有统计学意义(P<0.05);两组并发症发生率比较,差异无统计学意义(P>0.05)。结论:输尿管软镜钬激光碎石术治疗嵌顿性输尿管结石患者可缩短首次下床活动时间、手术时间和住院时间,减少术中出血量,提高一次性结石清除率,降低炎性指标和肾功能指标水平的效果优于经皮肾镜取石术治疗。Objective:To compare effects offlexible ureteroscopic holmium laser lithotripsy and percutaneous nephrolithotomy in the treatment of patients with impacted ureteral calculus.Methods:A prospective study was conducted on 62 patients with impacted ureteral calculus admitted to the hospital from October 2020 to October 2023.According to the random number table method,they were divided into control group and study group,31 cases in each group.The study group was treated withflexible ureteroscopic holmium laser lithotripsy,while the control group was treated with percutaneous nephrolithotomy.The levels of operation-related indicators(first out-of-bed time,operation time,hospitalization time,intraoperative blood loss,one-time stone clearance rate),inflammatory indicators[white blood cell count(WBC),C-reactive protein(CRP),interleukin-6(IL-6),procalcitonin(PCT)],renal function indicators[serum creatinine(Scr),cystatin C(CysC)],and the incidence of postoperative complications were compared between the two groups.Results:Thefirst out-of-bed time,the operation time and the hospitalization time in the study group were shorter than those in the control group,the intraoperative blood loss was less than that in the control group,the one-time stone clearance rate was higher than that in the control group,and the differences were statistically significant(P<0.05).One day after the surgery,the levels of CRP,PCT,IL-6 and WBC in the two groups were higher than those before the surgery,but those in the study group were lower than those in the control group,and the differences were statistically significant(P<0.05).Three days after the surgery,the levels of Scr and CysC in the two groups were lower than those before the surgery,those in the study group were lower than those in the control group,and the differences were statistically significant(P<0.05).However,there was no significant difference in the incidence of complications between the two groups(P>0.05).Conclusions:Flexible ureteroscopic holmium laser lithotripsy for the patient

关 键 词：输尿管软镜钬激光碎石术 经皮肾镜取石术 嵌顿性输尿管结石 炎性指标 肾功能 结石清除率 并发症 

分 类 号：R693.4[医药卫生—泌尿科学]