MPCNL钬激光与气压弹道治疗输尿管结石的疗效比较

Comparison of MPCNL curative effect between holmium laser and pneumatic lithotripsy in the treatment of ureteral calculi

目的:探讨微通道经皮肾镜钬激光及气压弹道碎石取石对治疗输尿管上段结石的疗效。方法:选取60例输尿管上段结石患者,分成两组,每组30例,A组碎石能量使用钬激光,B组使用气压弹道。分析两组手术时间、住院时间、结石清除率、术后并发症上的区别。结果:钬激光组的平均手术时间明显小于气压弹道组(P<0.05),其术后留置肾造瘘管时间短于气压弹道组,术后住院时间和术后残石率上两种手术方式差异无统计学意义(P>0.05)。钬激光组有3例发生术后发热,而气压弹道组有11例术后发热,差异有统计学意义。总体而言钬激光组在手术时间、术后留置肾造瘘管时间及术后感染等方面优于气压弹道组。结论:微通道经皮肾镜钬激光与气压弹道碎石取石术均为治疗肾结石及输尿管上段结石的有效方法,在某些指标上钬激光具有优势,应根据实际情况选择不同手术方式。

Objective：To investigate the efficacy of microchannel percutaneous nephrolithotomy holmium laser and pneumatic lithotripsy in the treatment of upper ureteral calculi.Methods：A total of 60 patients with upper ureteral calculi were selected. The patients were divided into two groups： 30 patients in each group. Holmium laser was used in group A, and pneumatic lithotripsy was used in group B.Comparison of the two group in operation time, hospital stay, stone clearance rate, and postoperative complications.Results：The average operation time of holmium laser group was significantly lower than that of pneumatic lithotripsy group （P〈 0.05）.The postoperative removal time of renal stoma drainage was shorter than that of pneumatic lithotripsy group, There was no significant difference in postoperative hospitalization time and postoperative residual stone rate between the two groups （P〉 0.05）. There were 3 cases of postoperative fever in the holmium laser group, and 11 cases in the pneumatic lithotripsy group, which was statistically significant.Overall, in the operation time, postoperative indwelling renal fistula time and postoperative infection holmium laser group is superior to the pneumatic ballistic group.Conclusion：Microchannel percutaneous nephrolithotomy with holmium laser and pneumatic lithotripsy lithotripsy are both effective methods for the treatment of calculi and upper ureteral calculi. In some indicators, holmium laser has more advantages,and we need to choose surgical methods according to the actual situation.