基于肾功能评估经尿道输尿管镜下钬激光碎石术在输尿管结石中的治疗优势  

Evaluate the advantages of transurethral ureteroscopic holmium laser lithotripsy in the treatment of ureteral calculi based on renal function

作　　者：安源江 刘玉坤 顾玉彬[1] An Yuan-jing;Liu Yu-kun;Gu Yu-bin(Department of Urology,Taikang People's Hospital,Zhoukou 461499,Henan,China)

机构地区：[1]太康县人民医院泌尿外科,河南周口461499

出　　处：《四川生理科学杂志》2025年第3期563-565,678,共4页

摘　　要：目的:分析输尿管结石患者接受经尿道输尿管镜下钬激光碎石术(Ureteroscopy holmium laser lithotripsy,URHL)治疗方案后的相关指标变化情况。方法:将太康县人民医院2020年1月至2024年1月收治的201例输尿管结石患者根据随机数字表法分为对照组(100例,经尿道输尿管镜下气压弹道碎石术(Ureteroscopic lithotripsy,URSL))和观察组(101例,经尿道URHL治疗)。比较两组手术相关指标及碎石情况、肾功能指标、应激指标(术前、术后1 d)、并发症(术后3 w内)。结果:观察组的手术、住院时间更短,碎石成功率和结石排净率更高(P<0.05);术后1 d观察组血清肌酐(Serum creatinine,Scr)、尿素氮(Blood urea nitrogen,BUN)、胱抑素C(Cystatin C,CysC)水平低于对照组,对照组血清皮质醇(Cortisol,Cor)、去甲肾上腺素(Norepinephrine,NE)、C反应蛋白(C-reactive protein,CRP)水平高于观察组(P<0.05);术后3 w内观察组并发症总发生率低于对照组(P<0.05)。结论:相较于经尿道URSL治疗,经尿道URHL治疗可以更好地改善输尿管结石患者手术相关指标、碎石情况和肾功能,减轻其应激反应,整体安全性高。Objective:To analyze the changes of related indexes in patients with ureteral calculi after transurethral ureteroscopic holmium laser lithotripsy(URHL)treatment.Methods:According to the random number table method,201 patients with ureteral calculi admitted to Taikang County People's Hospital from January 2020 to January 2024 were divided into the control group(100 cases,transurethral ureteroscopic pneumatic lithotripsy(URSL))and the observation group(101 cases,transurethral URHL treatment).The operation related indexes,lithotripsy,renal function indexes,stress indexes(before operation and 1 day after operation)and complications(within 3 weeks after operation)were compared between the two groups.Results:The operation and hospitalization time of the observation group were shorter,and the success rate of lithotripsy and stone clearance rate were higher(P<0.05).The levels of serum creatinine(Scr),urea nitrogen(BUN)and cystatin C(CysC)of the observation group were lower than those of the control group at 1 day after operation.The levels of serum cortisol(Cor),norepinephrine(NE)and C-reactive protein(CRP)of the control group were higher than those of the observation group(P<0.05).The total incidence of complications of the observation group was lower than that of the control group within 3 weeks after operation(P<0.05).Conclusion:Compared with transurethral URSL treatment,transurethral URHL treatment could better improve the operation-related indicators,lithotripsy and renal function of patients with ureteral calculi,reduce their stress response,and have high overall safety.

关 键 词：钬激光碎石术 气压弹道碎石术 输尿管结石 肾功能 

分 类 号：R69[医药卫生—泌尿科学]