输尿管软镜下钬激光碎石术治疗不同直径的上尿路结石疗效对照研究

A comparative study of holmium laser lithotripsy under ureteroscope for the treatment of upper urinary calculi with different diameters

目的对比输尿管软镜下钬激光碎石术治疗不同直径的上尿路结石疗效,为上尿路结石治疗提供参考。方法选取拟行手术治疗的上尿路结石患者94例,根据结石直径大小分为大结石组(结石直径>20 mm)与小结石组(结石直径≤20 mm),分别有21例与73例,行输尿管软镜下钬激光碎石术治疗,观察疗效。结果大结石组手术时间、术中出血量、术后住院时间分别为(114.86±26.77)min、(20.20±7.73)ml、(3.45±1.15)d,长于(多与)小结石组(67.94±20.81)min、(13.46±6.92)ml、(2.31±0.73)d(P<0.05);小结石组与大结石组一次碎石成功率分别为98.63%、95.24%,比较差异无统计学意义,一次性碎石结石清除率小结石组为91.78%高于大结石组71.43%(P<0.05);并发症发生率两组比较差异无统计学意义。结论输尿管软镜下钬激光碎石术治疗上尿路结石疗效肯定,但是治疗直径小的结石疗效明显优于大结石。

Objective To compare the efficacy of holmium laser lithotripsy under ureteroscope for the treatment of upper urinary calculi with different diameters,so as to provide reference for the treatment of upper urinary calculi.Methods94cases of patients with upper urinary calculi underwent surgery to select,according to the size of the calculus was divided into large stone group(stone diameter>20mm)and small stone group(stone diameter less than20mm),there were21cases and73cases underwent flexible ureteroscopic holmium laser lithotripsy for treatment,observation of curative effect.Results The large stone group operation time,intraoperative bleeding volume,postoperative hospitalization time was(114.86±26.77)min,(20.20±7.73)ml,(3.45±1.15)d,(and)longer than the small stone group(67.94±20.81)min,(13.46±6.92)ml,(2.31±0.73)d(P<0.05);small stone group and large stone group a gravel success rate were98.63%,95.24%,the difference was not statistically significant,one-time stone clearance rate of stones stones group was91.78%higher than that of large stone group71.43%(P<0.05);the complication rate difference between the two groups was not statistically significant.Conclusion Holmium laser lithotripsy under ureteroscope is effective in the treatment of upper urinary calculi,but the treatment of small diameter stones is superior to that of large stones.