输尿管镜下钬激光碎石术治疗输尿管结石的临床效果观察  

Clinical observation of ureteroscopic holmium laser lithotripsy in the treatment of ureteral calculus

作　　者：邓乃刚 胡金鼎[1] 程镇[1] 翟利然 DENG Naigang;HU Jinding;CHENG Zhen;ZHAI Liran(Department of Urology,The Second People's Hospital of Liaocheng,Liaocheng,Shandong 252699,China)

机构地区：[1]聊城市第二人民医院泌尿外科,山东聊城252699

出　　处：《医药前沿》2025年第12期56-59,共4页Journal of Frontiers of Medicine

摘　　要：目的观察输尿管镜下钬激光碎石术治疗输尿管结石的临床效果。方法选取2022年5月—2023年10月聊城市第二人民医院收治的80例输尿管结石患者,按治疗方法不同分为两组各40例。对照组采用传统开放手术治疗,观察组采用输尿管镜下钬激光碎石术治疗。比较两组手术相关指标、肾功能(尿素氮、血肌酐)、应激反应[促肾上腺皮质激素(ACTH)、肾上腺素(E)、皮质醇(COR)]、炎症指标[白细胞计数、C反应蛋白(CRP)]、生活质量评分、并发症发生率。结果观察组术中出血量少于对照组,手术时间、结石排净时间、住院时间均短于对照组(P<0.05);术后24 h,两组尿素氮、血肌酐、白细胞计数、CRP、ACTH、E、COR水平均低于术前,且观察组低于对照组(P<0.05);术后3个月,两组生活质量各项评分均高于术前,且观察组高于对照组(P<0.05);观察组并发症总发生率低于对照组(P<0.05)。结论输尿管镜下钬激光碎石术治疗输尿管结石患者效果显著,可减轻机体应激反应,降低炎症水平,有助于促进患者肾功能、生活质量的改善,且并发症少,利于术后康复。Objective To observe the clinical effect of ureteroscopic holmium laser lithotripsy in the treatment of ureteral calculus.Methods A total of 80 patients of ureteral calculus admitted to The Second People's Hospital of Liaocheng from May 2022 to October 2023 were divided into two groups according to the different treatment methods,with 40 cases in each group.The control group underwent conventional open surgery,and the observation group underwent ureteroscopic holmium laser lithotripsy.The operation related indexes,renal function(urea nitrogen,serum creatinine),stress response[adrenocorticotrophin(ACTH),epinephrine(E),cortisol(COR)],inflammation index[white blood cell count,C-reactive protein(CRP)],quality of life score,and complication rate were compared between the two groups.Results The intraoperative blood loss in the observation group was less than that in the control group,and the operation time,stone clearance time and hospitalization time were shorter than those in the control group,the differences were statistically significant(P<0.05);at 24 hours after operation,the urea nitrogen,serum creatinine,white blood cell count,CRP and the levels of ACTH,E and COR in the two groups were lower than those before operation,and those in the observation group were lower than the control group(P<0.05);at 3 months after operation,the scores of quality of life in the two groups were higher than those before operation,and those in the observation group were higher than the control group(P<0.05);the total incidence of complications in the observation group was lower than that in the control group(P<0.05).Conclusions Ureteroscopic holmium laser lithotripsy is effective in the treatment of patients with ureteral calculi,which can reduce the stress response of the body,reduce the level of inflammation,help to promote the improvement of patients'kidney function and quality,and have fewer complications,which is conducive to postoperative rehabilitation of patients.

关 键 词：输尿管结石 肾功能 炎症指标 输尿管镜下钬激光碎石术 并发症 

分 类 号：R693[医药卫生—泌尿科学]