用经输尿管硬镜钬激光碎石术对单侧输尿管多发结石患者进行治疗的效果研究

Holmium laser lithotripsy via ureteroscope for the treatment of multiple calculi in single ureter

目的:探讨使用经输尿管硬镜钬激光碎石术对单侧输尿管多发结石患者进行治疗的临床效果。方法:选取2018年1月至2019年1月在重庆两江新区第一人民医院进行治疗的76例单侧输尿管多发结石患者作为研究对象。将其随机分为甲组(n=38)和乙组(n=38)。使用经输尿管硬镜钬激光碎石术对甲组患者进行治疗。使用经输尿管硬镜气压弹道碎石术对乙组患者进行治疗。然后,比较两组患者皮质醇(Cor)的水平、丙二醛(MDA)的水平、超氧化物歧化酶(SOD)的水平、血肌酐(Scr)的水平、尿素氮(BUN)的水平、进行手术的时间、住院的时间、碎石的成功情况、结石的排尽情况及并发症的发生情况。结果:治疗后,甲组患者Cor的水平、MDA的水平、Scr的水平、BUN的水平及并发症的总发生率均低于乙组患者,P<0.05;甲组患者SOD的水平、碎石的成功率及结石的排尽率均高于乙组患者,P<0.05;甲组患者进行手术的时间和住院的时间均短于乙组患者,P<0.05。结论:使用经输尿管硬镜钬激光碎石术对单侧输尿管多发结石患者进行治疗,可降低其并发症的发生率,减轻其氧化应激反应,提高其临床疗效,促使其较快地康复,改善其肾功能。

Objective:To investigate the clinical effect of transureteroscopic holmium laser lithotripsy in the treatment of multiple calculi in single ureter.Methods:76 patients with unilateral ureteral multiple calculi who were treated in The First People’s Hospital of Liangjiang New District,Chongqing from January 2018 to January 2019 were selected as study subjects.They were randomly divided into group A(n=38)and group B(n=38).Ureteroscopic holmium laser lithotripsy was used to treat patients in group A.The patients in group B were treated with transureteral rigid endoscopic pneumatic lithotripsy.Then,to compare two groups of patients the levels of cortisol(Cor),malondialdehyde(MDA)level and the levels of superoxide dismutase(SOD),the levels of serum creatinine(Scr),the levels of urea nitrogen(BUN),surgery time,hospitalization time,the success of the gravel,stone line conditions and complications.Results:After treatment,the level of Cor,MDA,Scr,BUN and the total incidence of complications in group A were lower than those in group B(P<0.05).The level of SOD,the success rate of lithotripsy and the stone excretion rate in group A were all higher than those in group B(P<0.05).The duration of operation and hospitalization in group A was shorter than that in group B(P<0.05).Conclusion:Transureteroscopic holmium laser lithotripsy for the treatment of multiple ureteral calculi can reduce the incidence of complications,reduce the oxidative stress response,improve the clinical efficacy,promote rapid recovery,and improve renal function.