输尿管镜下钬激光碎石术治疗输尿管结石效果

Curative Effect Observation of Ureteroscopic Holmium Laser Lithotripsy for Ureteral Calculi

目的观察输尿管镜下钬激光碎石术在输尿管结石中的治疗效果。方法采用双色球分组法将70例输尿管结石患者分为观察组与对照组,各35例。对照组采取气压弹道碎石术,观察组实施输尿管镜下钬激光碎石术。比较2组患者围术期情况。结果观察组手术用时(31.52±20.25)min、下床活动时间(8.54±1.34)h及胃肠功能恢复时间(5.52±1.36)h,短于对照组的(75.52±12.64)min、(25.10±6.32)h及(13.32±2.29)h,观察组术中失血量(11.54±5.32)mL,少于对照组(59.52±9.51)mL,差异有统计学意义(P<0.05)。观察组术后血肌酐(112.25±14.42)μmol/L、尿素氮(4.37±1.12)mmol/L,均低于对照组的(129.56±16.21)μmol/L、(7.15±1.24)mmol/L,差异有统计学意义(P<0.05)。术后观察组皮质醇(241.58±29.31)pg/L、丙二醛(6.20±1.15)nmol/L,低于对照组的(270.54±30.36)pg/L、(9.54±1.32)nmol/L,观察组超氧化物歧化酶(71.56±16.32)NU/mL,高于对照组的(62.56±14.65)NU/mL,差异有统计学意义(P<0.05)。观察组一次性碎石率97.14%、结石排净率94.29%,高于对照组的77.14%、68.57%,差异有统计学意义(P<0.05)。结论输尿管结石采取输尿管镜下钬激光碎石术效果优于气压弹道碎石术。

Objective To observe the therapeutic effect of holmium laser lithotripsy under ureteroscopy in ureteral calculi.Methods 70 cases of ureteral calculi were divided into observation group(35 cases)and control group(35 cases).Pneumatic lithotripsy was used in the control group and holmium laser lithotripsy under ureteroscopy was used in the observation group.The perioperative conditions of the two groups were compared.Results The operation time in the observation group was(31.52±20.25)min,(8.54±1.34)h,the recovery time of gastrointestinal function was(5.52±1.36)h,and the blood loss was(11.54±5.32)mL,lower than that of control group(59.52±9.51)mL.The difference was statistical significance(P<0.05).The serum creatinine of the postoperative observation group(112.25±14.42)μmol/L,urea nitrogen(4.37±1.12)mmol/L was lower than that of the control group(129.56±16.21)μmol/L,(7.15±1.24)mmol/L.The difference was statistical significance(P<0.05).The postoperative cortisol(241.58±29.31)pg/L of the observation group was significantly lower than that of the control group(129.56±16.21)μmol/L,(7.15±1.24)mmol/L.Malondialdehyde(6.20±1.15)nmol/L was lower than control group(270.54±30.36)ng/L,and(9.54±1.32)nmol/L,superoxide dismutase(71.56±16.32)NU/mL was higher than that of control group(62.56±14.65)NU/mL.The one-time lithotripsy rate was 97.14%and the stone removal rate was 94.29%in the observation group,which was higher than that in the control group(77.14%,68.57%).The difference was statistical significance(P<0.05).Conclusion Ureteroscopic holmium laser lithotripsy is superior to pneumatic lithotripsy in ureteral calculi.