输尿管镜下钬激光碎石术对输尿管结石患者术后康复及结石排净率的影响

Effect of Holmium Laser Lithotripsy under Ureteroscope on Postoperative Recovery and Stone Removal Rate of Patients with Ureteral Calculi

目的:探讨输尿管镜下钬激光碎石术对输尿管结石患者术后康复及结石排净率的影响。方法:选取2018年2月-2019年7月笔者所在医院收治的输尿管结石患者115例,依照奇偶顺序分为研究组(58例)、对照组(57例)。对照组采用输尿管镜气压弹道碎石术治疗,研究组采用输尿管镜下钬激光碎石术治疗。比较两组手术指标(手术时间、术后血尿持续时间、住院时间)、结石排净率、并发症发生率、应激指标(血清皮质醇、丙二醛水平)。结果:研究组结石排净率为96.55%,高于对照组的75.44%,差异有统计学意义(P<0.05);研究组手术时间、术后血尿持续时间、住院时间均短于对照组,差异均有统计学意义(P<0.05);术后10 min研究组血清皮质醇、丙二醛水平均低于对照组,差异均有统计学意义(P<0.05);研究组术后并发症发生率为3.45%,低于对照组的17.54%,差异有统计学意义(P<0.05)。结论:输尿管结石患者采用输尿管镜下钬激光碎石术治疗,能缩短手术时间,清除结石,减轻应激反应,促进患者早期康复,安全性高。

Objective:To investigate the effect of holmium laser lithotripsy under ureteroscope on postoperative recovery and stone removal rate of patients with ureteral calculi.Method:From February 2018 to July 2019,115 patients with ureteral calculi in our hospital were selected and divided into the study group(58 cases)and the control group(57 cases)according to parity order.The control group was treated with ureteroscopy pneumatic lithotripsy,while the study group was treated with ureteroscopy holmium laser lithotripsy.The surgical indexes(duration of operation,duration of postoperative hematuria,length of hospital stay),stone removal rate,incidence of complications,and stress indexes(serum cortisol and malondialdehyde levels)of two groups were compared.Result:The stone removal rate of the study group was 96.55%,higher than that of the control group(75.44%),the difference was statistically significant(P<0.05).All the operative time,postoperative hematuria duration time and hospital stay time in the study group were shorter than those in the control group,the differences were statistically significant(P<0.05).At 10 minutes after operation,the serum cortisol and malondialdehyde levels in the study group were lower than those in the control group,the differences were statistically significant(P<0.05).The incidence of postoperative complications in the study group was 3.45%,lower than that in the control group(17.54%),the difference was statistically significant(P<0.05).Conclusion:Holmium laser lithotripsy under ureteroscope can shorten the operation time,clear the calculi,reduce the stress response,promote the early recovery of patients with ureteral calculi,with high safety.