输尿管镜钬激光碎石术与气压弹道碎石术治疗下段输尿管结石的临床疗效分析

Clinical Effects of Holmium Laser Lithotripsy and Pneumatic Lithotripsy in the Treatment of Lower Ureteral Calculi

目的:探讨输尿管镜钬激光碎石术与气压弹道碎石术治疗下段输尿管结石的临床疗效。方法:选取146例输尿管下段结石患者,将所有患者随机分为试验组和治疗组两组,其中试验组患者均采取输尿管镜钬激光碎石术进行治疗,而对照组患者则采取气压弹道碎石术进行治疗,比较两组患者手术前后的血清肌酐(Serum creatinine,Sc R)和血尿素氮(Blood urea nitrogen,BUN)等手术指标。结果:对照组患者完成手术所需要的时间和住院时间以及血尿时间均明显长于试验组患者,对照组患者之中的碎石成功率为71.91%(105例),明显低于试验组患者的碎石成功率84.25%(123例),两组患者之间的数据比较均有统计学意义(均P<0.05)。两组患者手术之前的BUN和Sc R水平均无明显差异,而在手术之后两组患者的BUN和Sc R水平均显著降低,并且试验组患者的降低幅度明显大于对照组患者(均P<0.05)。试验组患者在术后一个月时的结石排净率为94.52%,明显高于对照组患者的83.56%(P<0.05);试验组患者的并发症发生率为3.42%,明显低于对照组患者的13.01%(P<0.05);并且试验组患者的止痛药使用比例为20.00,明显低于对照组患者的34.62(均P<0.05)。结论:输尿管镜钬激光碎石术在治疗输尿管下段结石方面效果显著,且具有安全性高和创伤小以及恢复速度快等优势。

Objective：To analyze the clinical curative effects of ureteroscopy holmium laser lithotripsy and pneumatic ballistic lithotripsy in the treatment of lower segment ureteral calculi.Methods：146 patients with lower segment ureteral calculi from our hospital were selected in our study.According to the random number table method,all patients were randomly divided into trial group and control group.Patients of trial group were treated with ureteroscopy holmium laser lithotripsy,while those in control group were treated with pneumatic ballistic lithotripsy.The surgery indicators such as serum creatinine （ScR） and blood urea nitrogen （BUN） of patients were compared between two groups before and after operation.Results：Patients in control group had significantly longer surgery time,hospital stay and hematuria time than those in the trial group.In the control group,the success rate of lithotripsy was 71.91% （105 cases）,significantly lower than that of the trial group （84.25%,123 cases）.The differences between the two groups were statistically significant （all P〈0.05）.Before surgery,there were no obvious differences in the levels of BUN and ScR between the two groups.However,the BUN and ScR levels were significantly decreased after surgery in both groups,and they decreased greater in the trial group than in the control group （all P〈0.05）.In trial group,the stone-free rate was 94.52% at one month after surgery,significantly higher than that of 83.56% in the control group （P〈0.05）.The incidence of complications was 3.42% in the trial group,significantly lower than that 13.01% of the control group （P〈0.05）.Moreover,the paregoric using ratio was 20.00 in the trial group,but was 34.62 in the control group.The difference was statistically significant （P〈0.05）.Conclusion：Holmium laser lithotripsy is effective in the treatment of lower ureteral calculi,and it has advantages of high safety,less trauma and quick recovery.It is worth of wide use in clinical practice.