输尿管镜下钬激光碎石术治疗输尿管中、下段结石的效果

Effect of ureteroscopic holmium laser lithotripsy in the treatment of middle and lower ureteral calculi

目的探究输尿管镜下钬激光碎石术治疗输尿管结石的临床效果。方法选取2013年1月~2017年1月我院收治的110例输尿管中、下段结石患者作为研究对象,随机分为对照组(n=54)与观察组(n=56),分别接受输尿管镜下气压弹道碎石术与输尿管镜下钬激光碎石术。比较两组患者输尿管结石的清除效果、围术期指标及安全性。结果观察组结石清除率为89.3%,与对照组结石清除率(94.4%)比较,差异无统计学意义(P>0.05);术后1年观察组的结石复发率为5.4%,对照组结石复发率为1.9%,两组比较,差异无统计学意义(P>0.05);观察组的手术时间、住院时间及胃肠功能恢复时间均明显短于对照组,术中出血量少于对照组,术后镇痛药物使用率明显低于对照组,差异有统计学意义(P<0.05);两组患者的并发症发生率比较,差异无统计学意义(P>0.05)。结论输尿管镜下钬激光碎石术治疗输尿管中、下段结石效果优于输尿管镜下气压弹道碎石术,术后损伤小、恢复快,值得临床推广运用。

Objective To explore the clinical effect of ureteroscopic holmium laser lithotripsy and laparoscopic ureterolithotomy in the treatment of ureteral calculi.Methods A total of 110 patients with middle and lower ureteral calculi treated from January 2013 to January 2017 were randomly divided into the control group（n=54） and the observation group（n=56）.The ureteroscopic pneumatic lithotripsy and the ureteroscopic holmium laser lithotripsy were performed respectively.The clearance effect,perioperative indicators and safety of two groups were compared.Results The stone clearance rate in the observation group was 89.3%,the control group was 94.4%,the difference was not statistically significant（P〉0.05）.In 1 years after operation,the recurrence rate of stones in observation group was 5.4%,while in control group,stone recurrence rate was 1.9%,there was no significant difference between two groups（P〉0.05）.The operation time,the time of hospitalization and the recovery time of gastrointestinal function in the observation group were significantly shorter than those in the control group,the amount of bleeding in the operation was significantly less than that in the control group,and the postoperative analgesic drug use rate was significantly lower than that in the control group,the difference was statistically significant（P〈0.05）.There was no significant difference in the incidence of complications between the two groups（P〉0.05）.Conclusion The effect of ureteroscopic holmium laser lithotripsy in the treatment of middle and lower ureteral calculi is better than that of ureteroscopic pneumatic lithotripsy.The postoperative injury is small,the recovery is fast.It is worthy of clinical application.