经输尿管镜钬激光碎石术对输尿管结石患者肾功能指标的影响

Effect of Ureteroscopic Holmium Laser Lithotripsy on Renal Function Indexes of Patients with Ureteral Calculi

目的探讨经输尿管镜钬激光碎石术对输尿管结石患者肾功能指标的影响。方法选择2018年9月-2020年2月我院收治的92例输尿管结石患者,采用随机数字表法分为两组,各46例。研究组采用经输尿管镜钬激光碎石术,对照组采用输尿管镜下气压弹道碎石术。对比两组临床疗效、围术期指标、治疗前后肾功能指标水平及并发症情况。结果研究组总有效率为93.48%,高于对照组的78.26%,差异有统计学意义(P<0.05);研究组手术时间为(46.52±7.29)min、住院时间为(3.51±0.94)d,短于对照组的(59.38±9.27)min、(5.88±1.36)d;研究组术中失血量为(15.08±2.57)m L少于对照组的(19.69±2.26)m L,差异有统计学意义(P<0.05);研究组治疗后血清肌酐水平为(230.86±56.14)mmol/L、尿素氮水平为(15.18±8.34)mmol/L,均低于对照组的(597.49±90.05)mmol/L、(24.39±8.10)mmol/L,内生肌酐清除率为(23.46±9.85)m L/min,高于对照组的(15.97±8.20)m L/min,差异有统计学意义(P<0.05);研究组并发症发生率为4.35%,低于对照组的17.39%,差异具有统计学意义(P<0.05)。结论采用经输尿管镜钬激光碎石术治疗输尿管结石对患者造成的创伤较小,安全可靠,疗效确切。

Objective This paper aims to investigate the effect of transureteroscopic holmium laser lithotripsy on renal function indexes of patients with ureteral calculi.Methods A total of 92 cases with ureteral calculi admitted to our hospital from September 2018 to February 2020 were selected and divided into two groups with 46 cases in each group by random number table method.Ureteroscopic holmium laser lithotripsy was used in the study group,and ureteroscopic pneumatic lithotripsy was used in the control group.The clinical efficacy,perioperative indexes,renal function levels before and after treatment and complications were compared between the two groups.Results The total effective rate of the study group was 93.48%,higher than 78.26%of the control group,the difference was statistically significant(P<0.05);The operative time(46.52±7.29)min and the hospitalization time(3.51±0.94)d in the study group were shorter than those in the control group’s(59.38±9.27)min and(5.88±1.36)d,and the intraoperative blood loss(15.08±2.57)m L was less than(19.69±2.26)m L of the control group,the difference were statistically significant(P<0.05);The serum creatinine level(230.86±56.14)mol/L and urea nitrogen level(15.18±8.34)mmol/L in the study group were lower than(597.49±90.05)mol/L and(24.39±8.10)mmol/L of the control group,and the clearance rate of endogenous creatinine(23.46±9.85)m L/min was higher than(15.97±8.20)m L/min of the control group,the differences were statistically significant(P<0.05).The complication rate of the study group was 4.35%,lower than that of the control group(17.39%),the difference was statistically significant(P<0.05).Conclusion Ureteroscopic holmium laser lithotripsy for ureteral calculi causes less trauma,which is safe,reliable and effective.