输尿管软镜钬激光碎石取石术与体外冲击波碎石术治疗上尿路结石疗效比较

Comparison of flexible ureteroscopic holmium laser lithotripsy and extracorporeal shock wave lithotripsy in the treatment of upper urinary tract calculi

目的探讨并比较输尿管软镜钬激光碎石取石术与体外冲击波碎石术对上尿路结石的疗效。方法选取2018年5月至2022年4月苏州市相城人民医院收治的80例上尿路结石患者作为研究对象,按照随机数字表法分为常规组与试验组,每组40例。常规组采用体外冲击波碎石术治疗,试验组采用输尿管软镜钬激光碎石术治疗。比较两组患者手术相关指标、氧化应激水平[超氧化物歧化酶(superoxide dismutase,SOD)与丙二醛(malondialdehyde,MDA)水平]、术后4周结石清除率及并发症发生情况。结果试验组住院时间、手术时间均短于常规组,差异有统计学意义(P<0.05)。术前,两组MDA、SOD水平比较,差异无统计学意义(P>0.05);术后2 d,两组SOD水平升高,MDA水平降低,且试验组术后2 d SOD水平高于常规组,MDA水平低于常规组,差异有统计学意义(P<0.05)。试验组术后4周结石清除率(92.50%)高于常规组(75.00%),差异有统计学意义(P<0.05)。两组并发症发生率比较,差异无统计学意义(P>0.05)。结论采用输尿管软镜钬激光碎石术治疗上尿路结石患者可缩短住院、手术时间,有利于改善患者氧化应激水平,提高其结石清除率,安全可靠。

Objective To investigate the efficacy of ureteroscopic holmium laser lithotripsy and extracorporeal shock wave lithotripsy in the treatment of upper urinary tract stones.Methods A total of 80 patients with upper urinary tract stones admitted to Suzhou Xiangcheng People's Hospital from May 2018 to April 2022 were selected as the study subjects.They were randomly divided into a conventional group and an experimental group using a random number table method,with 40 patients in each group.The conventional group was treated with extracorporeal shock wave lithotripsy,while the experimental group was treated with flexible ureteroscopic holmium laser lithotripsy.Compare the surgical related indicators,oxidative stress levels[levels of superoxide dismutase(SOD)and malondialdehyde(MDA)],stone clearance rate,and incidence of complications between two groups of patients.Results The length of hospital stay and operation time of the experimental group were shorter than those of the conventional group,and the difference was statistically significant(P<0.05).There was no significant difference in MDA and SOD levels between the two groups before surgery(P>0.05).2 days after surgery,SOD level was increased and MDA level was decreased in both groups,the SOD level of the experimental group was higher than that of the conventional group,and the MDA level was lower than that of the conventional group,and the difference was statistically significant(P<0.05).The stone clearance rate 4 weeks after surgery was significantly different between the two groups(P<0.05),and the stone clearance rate of the experimental group(92.50%)was higher than that of the conventional group(75.00%).There was no significant difference in the total incidence of complications between two groups(P>0.05).Conclusion Compared with extracorporeal shock wave lithotripsy,flexible ureteroscopic holmium laser lithotripsy can shorten hospital stay and operation time for patients with upper urinary tract calculi,improve the level of oxidative stress,and increase the stone clearance rate of patients,safe and reliable,worthy of promotion and application.