经尿道输尿管软镜联合钬激光碎石取石术在治疗肾结石中的临床应用及有效性评估  

Clinical Application and Evaluation of the Effectiveness of Transurethral Flexible Ureferoscope Combined with Holmium Laser Lithotripsy in the Treatment of Renal Stones

作　　者：宋伟强 张金刚 SONG Weiqiang;ZHANG Jin'gang(Department of Urology,Heze Hospital of Traditional Chinese Medicine,Heze,Shandong,274000,China;Depart-ment of Urology,Mudan District People's Hospital,Heze,Shandong,274000,China)

机构地区：[1]菏泽市中医医院泌尿外科,山东菏泽274000 [2]菏泽市牡丹区人民医院泌尿外科,山东菏泽274000

出　　处：《中外医疗》2024年第31期64-67,75,共5页China & Foreign Medical Treatment

摘　　要：目的探究经尿道输尿管软镜与钬激光碎石取石术(flexible ureteroscope holmium laser lithotripsy,FURSL)联合治疗肾结石的疗效及安全性,并与经皮肾镜碎石取石术的效果进行比较。方法随机选取2022年1月—2024年5月菏泽市中医医院收治的80例肾结石患者为研究对象,依据不同治疗方法分为A组、B组,各40例。A组接受经皮肾镜碎石取石术治疗,B组采用FURSL治疗,对比两组的手术相关指标、肾功能、炎症因子水平、并发症发生情况。结果B组术中失血量低于A组,手术操作时间、下床时间、住院时间均短于A组,差异有统计学意义(P均<0.05)。治疗前,两组患者的肾功能对比,差异无统计学意义(P>0.05);治疗后,两组患者的肾功能水平优于治疗前,且B组肾功能优于A组,差异有统计学意义(P均<0.05)。治疗前,两组患者的炎症因子水平对比,差异无统计学意义(P>0.05);治疗后,两组患者的炎症因子水平高于治疗前,但B组炎症因子水平低于A组,差异有统计学意义(P均<0.05)。治疗后,B组并发症总发生率为5.00%(2/40),低于A组的20.00%(8/40),差异有统计学意义(χ2=4.114,P<0.05)。结论相较于经皮肾镜碎石取石术,FURSL在治疗肾结石方面展现出更优的疗效和安全性,该手术方法不仅改善了手术相关指标,还有利于肾功能的恢复,并降低了炎症反应和并发症发生率。Objective To explore the efficacy and safety of flexible ureteroscope holmium laser lithotripsy(FURSL)in the treatment of renal calculi,and to compare the effect with percutaneous nephrolithotomy.Methods A total of 80 patients with renal calculi admitted to Heze Hospital of Traditional Chinese Medicine from January 2022 to May 2024 were randomly selected as the research objects.According to different treatment methods,they were divided into group A and group B,with 40 cases in each group.Group A was treated with percutaneous nephrolithotomy,and group B was treated with FURSL.The operation related indexes,renal function,inflammatory factors and complications were compared between the two groups.Results The intraoperative blood loss in group B was lower than that in group A,and the operation time,ambulation time and hospitalization time were shorter than those in group A,with statistically significant differences(all P<0.05).Before treatment,there was no significant difference in renal function between the two groups(P>0.05);after treatment,the renal function of the two groups was better than that before treatment,and the renal function of group B was better than that of group A,the difference was statistically significant(all P<0.05).Be fore treatment,there was no significant difference in the levels of inflammatory factors between the two groups(P>0.05);after treatment,the levels of inflammatory factors in the two groups were higher than those before treatment,and the levels of inflammatory factors in group B were lower than those in group A,the differences were statistically signifi cant(all P<0.05).After treatment,the total incidence of complications in group B was 5.00%(2/40),which was lower than 20.00%(8/40)in group A,and the difference was statistically significant(χ2=4.114,P<0.05).Conclusion Com pared with percutaneous nephrolithotomy,FURSL shows better efficacy and safety in the treatment of renal calculi.This surgical method not only improves the operation-related indicators,but also facilitates the reco

关 键 词：输尿管软镜 钬激光碎石取石术 经皮肾镜碎石取石术 临床疗效 安全性评估 

分 类 号：R699.2[医药卫生—泌尿科学]