探讨输尿管软镜下钬激光碎石术治疗上尿路结石的疗效及影响碎石成功率的因素和手术技巧

To Investigate the Effect of Holmium Laser Lithotripsy under Soft Ureteroscope on Upper Urinary Calculi, the Factors Affecting the Success Rate of Lithotripsy and the Surgical Techniques

目的探讨输尿管软镜下钬激光碎石术治疗上尿路结石的疗效及影响碎石成功率的因素和手术技巧。方法选择64例上尿路结石患者为试验对象,均采用输尿管软镜下钬激光碎石术治疗,随后根据治疗效果,分为治疗成功组(n=50)、治疗失败组(n=14),并统计两组患者术前影响因素。结果治疗成功组≤40岁率(70.00%)、病程≤3个月率(80.00%)、无血尿率(70.00%)高于治疗失败组,同时年龄(回归系数:0.2361;标准误:0.6395;OR:4.3956;P值:0.0001)、病程(回归系数:0.1986;标准误:0.5539;OR:5.9563;P值:0.0001)、血尿(回归系数:0.1745;标准误:0.7148;OR:4.0415;P值:0.0001)均是影响碎石成功率的主要原因。均是影响碎石成功率的主要原因。结论影响输尿管软镜下钬激光碎石术治疗成功的原因为年龄、病程、血尿,为了提高手术成功率,还需注意手术技巧。

Objective To investigate the effect of holmium laser lithotripsy under soft ureteroscope on upper urinary calculi, the factors that affect the success rate of lithotripsy, and surgical techniques. Methods Sixty-four patients with upper urinary calculi were selected as the test subjects. All were treated with holmium laser lithotripsy under soft ureteroscope, and then divided into treatment success group(n=50) and treatment failure group(n=14) according to the treatment effect. And statistics of preoperative influencing factors of the two groups of patients. Results The treatment success group was ≤40 years old(70.00%), the course of disease was ≤3 months(80.00%), and the hematuria rate(70.00%) was higher than the treatment failure group, and the age(regression coefficient : 0.2361;standard error : 0.6395;OR: 4.3956;P value: 0.0001), course of disease(regression coefficient : 0.1986;standard error : 0.5539;OR: 5.9563;P value: 0.0001), hematuria(regression coefficient: 0.1745;standard error : 0.7148) OR: 4.0415;P value: 0.0001) are the main reasons affecting the success rate of lithotripsy. All are the main reasons affecting the success rate of lithotripsy. Conclusion The reasons affecting the success of holmium laser lithotripsy under soft ureteroscope are age, course of disease, and hematuria. In order to improve the success rate of surgery, attention should also be paid to surgical techniques.