钬激光碎石治疗肾盂及输尿管上段结石的效果观察

Effect Observation of Holmium Laser Lithotripsy in Treatment of Pelvis and Upper Ureter Calculi

目的探讨经皮肾镜钬激光碎石术治疗肾盂及输尿管上段结石的效果与安全性。方法选择肾盂及输尿管上段结石85例,随机分为钬激光碎石术治疗组(钬激光组)41例及气压弹道碎石术治疗组(气压弹道组)44例,比较两组碎石时间、残石率、住院时间及并发症发生率。结果术中肾盂结石、输尿管上段结石碎石时间钬激光组分别为(15.2±1.5)min、(5.6±1.3)min,气压弹道组分别为(23.6±1.7)min、(9.1±1.2)min,两组比较差异有统计学意义(P<0.01);钬激光组术后复查肾盂及输尿管残石率(长径以>5 mm计)分别为5.3%、4.5%,气压弹道组分别为13.0%、9.5%,差异有统计学意义(P<0.01)。两组出血量比较差异无统计学意义(P>0.05),术后均常规留置肾造瘘管及导尿管。结论钬激光碎石术治疗肾盂及输尿管上段结石效果较好,安全可靠。

Objective To discuss the effect and safety of percutaneous nephroscope set holmium laser lithotripsy in treatment of pelvis and upper ureter calculi.Methods A total of 85 patients with renal pelvic and upper ureteral calculi were randomly divided into group A （n =41）,which was treated with holmium laser lithotripsy and group B （n =44）,which was treated with pneumatic lithotripsy,and lithotripsy time,residual stone rate,hospitalization time and incidence rate of complications in the two groups were compared.Results The intraoperative lithotripsy times for pelvis and upper ureter calculi were （15.2 ± 1.5） min and （5.6 ± 1.3） min respectively in group A,while the times were （23.6 ± 1.7） min and （9.1 ± 1.2） min respectively in group B,and the differences were statistically significant （P ＜ 0.01）; the residual stone （＞ 5 mm） rates for pelvis and upper ureter calculi were 5.3％ and 4.5％ respectively in group A,while the rates were 13.0％ and 9.5％ respectively in group B,and the differences were statistically significant （P ＜0.01）.There was no significant difference in blood loss in the two groups （P ＞0.05）,and all the patients were inserted with nephrostomy tube and catheter.Conclusion Holmium laser lithotripsy is effective and safe in treatment of pelvis and upper ureter calculi.