钬激光碎石取石术治疗泌尿结石临床探讨

Clinical Study on the Treatment of Urinary Calculi with Holmium Laser Lithotripsy

目的:探讨钬激光碎石取石术治疗泌尿结石的临床疗效。方法:选取2013年4月-2015年1月本院接诊的120例泌尿结石患者作为研究对象,采用抽签法随机抽取60例患者行钬激光碎石取石术为观察组,采用国产爱科凯能30W钬激光仪、经脾肾镜、输尿管肾镜、活检钳等进行诊断,全麻并确定结石位置后置入激光光纤,在输尿管肾镜下切除结石;另60例患者行常规的排石汤治疗为对照组。观察两组的治疗效果,并比较两组的并发症发生情况。结果:观察组行钬激光碎石取石术的60例患者均一次性取石成功;观察组的治疗总有效率96.7%明显高于对照组的76.7%,两组比较差异有统计学意义(字2=10.385,P<0.05);观察组的并发症总发生率3.3%明显低于对照组的20.0%,两组比较差异有统计学意义(字2=8.086,P<0.05)。结论:钬激光碎石取石术治疗泌尿结石可有效提高取石成功率,其具有一定的手术安全性,可在临床推广使用。

Objective： To evaluate the clinical efficacy of lithotripsy treatment of urinary calculi in holmium laser lithotripsy.Method： 120 urinary stone patients as research subjects were selected in our hospital from April 2013 to January 2015,they were randomly divided into two groups, 60 cases in each group. The observation group was treated holmium laser lithotripsy,the use of domestic AGCO Kay 30 W holmium laser, the spleen mirror, ureterorenoscopy and biopsy forceps were used to diagnose, after anesthesia and determine stone location implantation laser fiber, endoscopic resection of renal stones in the ureter.The control group was treated conventional row of stone soup.The therapeutic effect and incidence of complications of two groups were observed and compared.Result： The observation group with holmium laser lithotripsy, 60 patients were stone-time success.The treatment total effective rate of observation group was 96.7%,which was significantly higher than control group＇s 76.7%,compared the difference of two groups was statistically significant（ χ2=10.385,P〈0.05）.Total complication rate of the observation group was 3.3%,which was significantly lower than the control group of 20.0%,the difference was statistically significant（ χ2=8.086,P〈0.05）.Conclusion：Holmium laser lithotripsy treatment of urinary stones can effectively improve the success rate of stone, it has a certain surgical safety,can be used in clinical practice.