微通道经皮肾镜取石术与输尿管软镜钬激光碎石术对输尿管上段结石患者围术期指标及并发症的影响对比  

Comparison of Effects of Microchannel Percutaneous Nephrolithotomy and Flexible Ureteroscope Holmium Laser Lithotripsy on Perioperative Indicators and Complications in Patients with Upper Ureteral Calculi

作　　者：魏长宏[1] WEI Changhong(Department of Urology,Zaozhuang Xuecheng District People's Hospital,Zaozhuang 277000,China)

机构地区：[1]枣庄市薛城区人民医院泌尿外科,山东枣庄277000

出　　处：《反射疗法与康复医学》2024年第21期83-86,共4页Reflexology And Rehabilitation Medicine

摘　　要：目的探讨微通道经皮肾镜取石术与输尿管软镜钬激光碎石术对输尿管上段结石患者围术期指标及并发症的影响。方法回顾性分析2021年7月—2023年7月枣庄市薛城区人民医院收治的84例输尿管上段结石患者的临床资料,按手术方式不同将其分为对照组和观察组,每组42例。对照组采用微通道经皮肾镜取石术治疗,观察组采用输尿管软镜钬激光碎石术治疗。比较两组的围术期指标、炎症、应激反应指标、疼痛程度、并发症发生情况。结果观察组手术时间、住院时间均短于对照组,术中出血量少于对照组,组间差异有统计学意义(P<0.05);两组一次性碎石成功率、结石取净率、并发症发生率比较,组间差异无统计学意义(P>0.05)。术前,两组C反应蛋白、降钙素原、皮质醇水平比较,组间差异无统计学意义(P>0.05);术后24 h,观察组C反应蛋白、降钙素原、皮质醇水平均低于对照组,组间差异有统计学意义(P<0.05)。术前,两组疼痛视觉模拟评分比较,差异无统计学意义(P>0.05);术后24 h,观察组疼痛视觉模拟评分为(4.63±0.34)分,低于对照组的(5.90±0.59)分,差异有统计学意义(P<0.05)。结论微通道经皮肾镜取石术与输尿管软镜钬激光碎石术治疗输尿管上段结石均具有较高的结石清除率,且并发症发生率较低,但输尿管软镜钬激光碎石术术中出血量少,手术及住院时间均较短,炎症、应激反应较小,且术后疼痛程度较轻。Objective To explore the effects of microchannel percutaneous nephrolithotomy and flexible ureteroscope holmium laser lithotripsy on the perioperative indicators and complications in patients with upper ureteral calculi.Methods A retrospective analysis was conducted on the clinical data of 84 patients with upper ureteral calculi admitted to Zaozhuang Xuecheng District People's Hospital from July 2021 to July 2023,according to different surgical methods,they were divided into a control group and an observation group,with 42 cases in each group.The control group was treated with microchannel percutaneous nephrolithotomy,while the observation group was treated with flexible ureteroscope holmium laser lithotripsy.The perioperative indicators,inflammation and stress response indicators,pain levels,and the occurrence of complications were compared between the two groups.Results The operation time and hospitalization time in the observation group were shorter than those in the control group,and the amount of intraoperative bleeding was less than that in the control group,and the differences between the groups were statistically significant(P<0.05);comparison of the success rates of one-time lithotripsy,complete stone removal rates,and complication occurrence rates between the two groups,and the differences between the groups were not statistically significant(P>0.05).Before the operation,the levels of C-reactive protein,procalcitonin and cortisol were compared between the two groups,and the differences between the groups were not statistically significant(P>0.05);at 24 hours after the operation,the levels of C-reactive protein,procalcitonin and cortisol in the observation group were lower than those in the control group,and the differences between the groups were statistically significant(P<0.05).Before the operation,the pain Visual Analogue Scale score were compared between the two groups,and the difference was not statistically significant(P>0.05);the pain Visual Analogue Scale score in the observation group was(4.63�

关 键 词：输尿管上段结石 微通道经皮肾镜取石术 输尿管软镜钬激光碎石术 围术期指标 疼痛 并发症 

分 类 号：R693.4[医药卫生—泌尿科学]