输尿管软镜钬激光碎石术与经皮肾镜碎石取石术在输尿管上段结石患者中的应用效果  

Application of Flexible Ureteroscopy Holmium Laser Lithotripsy and Percutaneous Nephrolithotomy in Patients with Upper Ureteral Calculi

作　　者：袁忠洪 YUAN Zhonghong(Department of Urology,Zunyi First People’s Hospital(Third Affiliated Hospital of Zunyi Medical College),Zunyi 563000,China)

机构地区：[1]遵义市第一人民医院(遵义医学院第三附属医院)泌尿外科,贵州遵义563000

出　　处：《反射疗法与康复医学》2025年第5期70-73,共4页Reflexology And Rehabilitation Medicine

摘　　要：目的 探讨输尿管软镜钬激光碎石术(FURL)与经皮肾镜碎石术(PCNL)在输尿管上段结石患者中的应用效果。方法 选取遵义市第一人民医院2021年1月—2023年12月收治的100例输尿管上段结石患者为研究对象,按随机数字表法将其分为对照组和观察组,各50例。对照组行PCNL治疗,观察组行FURL治疗。比较两组的手术情况、肾功能指标、术后疼痛程度、结石清除率及并发症发生情况。结果 观察组手术时间长于对照组,术中出血量少于对照组,术后住院时间短于对照组,术后血红蛋白降低值小于对照组,组间差异有统计学意义(P<0.05)。术后3 d,观察组尿素氮、血肌酐水平均低于对照组,组间差异有统计学意义(P<0.05)。术后12 h、术后48 h,观察组疼痛视觉模拟评分均低于对照组,组间差异有统计学意义(P<0.05)。两组结石清除率及并发症发生率对比,组间差异无统计学意义(P>0.05)。结论 FURL治疗输尿管上段结石患者效果更佳,可减轻机体创伤,降低疼痛程度,且未增加并发症发生,值得推广应用。Objective To investigate the application effect of flexible ureteroscopic holmium laser lithotripsy(FURL)and percutaneous nephrolithotomy(PCNL)in patients with upper ureteral calculi.Methods A total of 100 patients with upper ureteral calculi who were admitted to Zunyi First People’s Hospital from January 2021 to December 2023 were selected as the research objects,according to the random number table method,they were divided into a control group and an observation group,with 50 cases in each group.The control group was treated with PCNL,and the observation group was treated with FURL.The operation conditions,renal function indicators,degree of postoperative pain,stone clearance rate and complications were compared between the two groups.Results The operation time of the observation group was longer than that of the control group,the intraoperative blood loss was less than that of the control group,the postoperative hospital stay was shorter than that of the control group,and the reduction value of postoperative hemoglobin was less than that of the control group,and the differences between the two groups were statistically significant(P<0.05).Three days after operation,the levels of urea nitrogen and serum creatinine in the observation group were lower than those in the control group,and the differences between the two groups were statistically significant(P<0.05).At 12 hours and 48 hours after operation,the pain Visual Analogue Scale scores of the observation group were lower than those of the control group,and the differences between the two groups were statistically significant(P<0.05).There were no significant differences in stone clearance rate and complication rate between the two groups(P>0.05).Conclusion FURL is more effective in the treatment of patients with upper ureteral calculi,which can reduce body trauma and pain degree,and does not increase the incidence of complications,which is worthy of promotion and application.

关 键 词：输尿管上段结石 输尿管软镜钬激光碎石术 经皮肾镜碎石术 肾功能 疼痛程度 

分 类 号：R693.4[医药卫生—泌尿科学]