输尿管软镜钬激光碎石术与经皮肾镜取石术治疗肾结石的临床研究  

Clinical Study of Ureteral Flexible Holmium Laser Lithotripsy and Percutaneous Nephrolithotomy in the Treatment of Renal Calculus

作　　者：李波 LI Bo(Department of Urology,Renhuai Hospital of Traditional Chinese Medicine,Renhuai 564500,China)

机构地区：[1]仁怀市中医院泌尿外科,贵州仁怀564500

出　　处：《中国医学创新》2025年第7期44-47,共4页Medical Innovation of China

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在肾结石中的治疗效果。方法:选取2022年1月—2024年1月仁怀市中医院收治的80例肾结石患者,随机将患者分为观察组和对照组,每组40例。观察组行输尿管软镜钬激光碎石术,对照组行经皮肾镜取石术。比较两组一次性结石清除率、手术相关指标、术后疼痛及肾损伤情况。结果:两组一次性结石清除率比较,差异无统计学意义(P>0.05)。观察组手术时间长于对照组,失血量小于对照组,住院时间短于对照组,差异均有统计学意义(P<0.05)。观察组术后24、48、72 h的视觉模拟评分法(VAS)评分均低于对照组,差异均有统计学意义(P<0.05)。观察组术后5 d肾损伤分子-1(KIM-1)、胱抑素C(Cys C)和血尿素氮均低于对照组,肾小球滤过率(GFR)高于对照组,差异均有统计学意义(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与经皮肾镜取石术治疗肾结石的效果确切,但前者在缩短康复进程、减轻术后疼痛及促进肾功能恢复方面更具优势。Objective:To compare the efficacy of ureteral flexible holmium laser lithotripsy and percutaneous nephrolithotomy in the treatment of renal calculus.Method:A total of 80 patients with renal calculus admitted to Renhuai Hospital of Traditional Chinese Medicine from January 2022 to January 2024 were selected and randomly divided into observation group and control group,with 40 cases in each group.The observation group was treated with ureteral flexible holmium laser lithotripsy,and the control group was treated with percutaneous nephrolithotomy.The one-time stone clearance rate,operative related indexes,postoperative pain and kidney injury were compared between the two groups.Result:There was no significant difference in one-time stone clearance rate between the two groups(P>0.05).The operation time of the observation group was longer than that of the control group,the blood loss was less than that of the control group,and the hospitalization time was shorter than that of the control group,with statistical significance(P<0.05).The visual analogue scale(VAS)scores of the observation group 24,48 and 72 h after surgery were lower than those of the control group,the differences were statistically significant(P<0.05).Kidney injury molecular-1(KIM-1),cystatin C(Cys C)and blood urea nitrogen 5 days after surgery in observation group were lower than those in control group,and glomerular filtration rate(GFR)was higher than that in control group,the differences were statistically significant(P<0.05).There was no significant difference in the incidence of complications between the two groups(P>0.05).Conclusion:Ureteral flexible holmium laser lithotripsy and percutaneous nephrolithotomy are effective in the treatment of renal calculus,but the former has more advantages in shortening the rehabilitation process,alleviating postoperative pain and promoting the recovery of renal function.

关 键 词：肾结石 输尿管软镜钬激光碎石术 经皮肾镜取石术 疼痛 肾损伤 并发症 

分 类 号：R69[医药卫生—泌尿科学]