输尿管镜下钬激光碎石术对老年输尿管结石的治疗效果及对患者肾功能的影响

Effect of holmium laser lithotripsy on ureteral calculi in elderly patients and its influence on renal function

目的 探讨输尿管镜下钬激光碎石术治疗老年输尿管结石的疗效及对患者肾功能的影响.方法 选取2012年11月至2016年6月老年输尿管结石患者76例,根据手术方式分为两组,每组38例.观察组采用输尿管镜下钬激光碎石术,对照组采用气压弹道碎石术治疗,比较两组手术指标及肾功能指标.结果 观察组总有效率为97.4%（37/38）,高于对照组的78.9%（30/38）,差异有统计学意义（χ2=4.537,P＜0.05）.观察组手术时间、术后住院时间短于对照组,碎石成功率、结石排净率高于对照组,差异有统计学意义（P＜0.05）;术后2个月,观察组血肌酐、血尿素氮低于对照组,差异有统计学意义（P＜0.05）;观察组并发症发生率为2.6%（1/38）,低于对照组的21.0%（8/38）,差异有统计学意义（χ2=4.537,P＜0.05）.结论 老年患者输尿管结石采用输尿管镜下钬激光碎石术治疗能够缩短手术时间,提高碎石成功率和结石排净率,改善患者肾功能,安全可靠,值得推广.

Objective To investigate the effect of holmium laser lithotripsy on ureteral calculi in elderly patients and its influence on renal function.Methods A total of 76 elderly patients with ureteral calculus from November 2012 to June 2016 were selected, according to the operation methods, they were divided into two groups, with 38 cases in each group. The observation group was treated by holmium laser lithotripsy under ureter mirror, and the control group was given pneumatic lithotripsy. The surgery and renal function index were compared between the two groups.Results The total effective rate of the observation group was 97.4%（37/38）, which of the control group was 78.9%（30/38）, the difference was significant between the two groups （χ2=4.537,P〈0.05）. The operation time and postoperative hospital stay in the observation group were lower than those in the control group; the success rate of lithotripsy, the rate of stone discharge were higher than those in the control group, and the differences were significant （P〈0.05）. The complication rate of the observation group was 2.6% （1/38）, which was lower than [21.0%（8/38）] of the control group, and the difference was significant （χ2=4.537, P〈0.05）.Conclusions The treatment of ureteral calculi with holmium laser lithotripsy can shorten the operation time, improve the success rate of lithotripsy and stone drainage rate, and can improve renal function, so it is safety and reliability and be worthy of popularizing.