输尿管镜钬激光碎石处理输尿管膀胱段结石的临床研究

Clinical study of ureteroscopic holmium laser lithotripsy in the treatment of ureteral and bladder calculi

目的探究输尿管镜钬激光碎石处理输尿管膀胱结石的临床效果。方法选取2013年10月至2018年10月本院接诊的输尿管膀胱段结石患者80例作为研究对象,按照奇偶数排列法随机分成治疗组(n=40)和对照组(n=40)。对照组患者进行体外震波碎石,治疗组患者进行输尿管钬激光碎石,比较两组患者手术时间、术后导尿管留置时间、下床时间、住院时间及并发症。结果治疗组手术时间(28.46±3.46)min、术后导尿管留置时间(2.31±0.42)d、下床时间(4.23±1.72)d、住院时间(8.46±2.36)d;对照组手术时间(30.46±3.85)min、术后导尿管留置时间(4.28±0.76)d、下床时间(8.56±1.87)d、住院时间(14.86±2.74)d;两组手术时间比较差异无统计学意义;治疗组患者导尿管留置时间、下床时间及住院时间均明显短于对照组(P<0.05)。治疗组患者并发症发生率为2.5%,明显低于对照组的20.0%(P<0.05)。结论输尿管膀胱段结石患者采用输尿管镜钬激光碎石治疗操作简单,明显缩短导尿管留置时间、下床时间及住院时间,并发症少,与体外震波碎石相比更具优势,值得临床推广应用。

Objective To study the clinical effect of Ureteroscopic holmium laser lithotripsy in the treatment of ureter and bladder calculi.Methods From October 2013 to October 2018,80 patients with ureter and bladder calculi were randomly divided into treatment group(n=40)and control group(n=40)according to odd-even arrangement.The patients in the control group were treated with extracorporeal shock wave lithotripsy,and the patients in the treatment group were treated with holmium laser lithotripsy.The operation time,catheter indwelling time,stay out of bed,hospitalization time and complications were compared between the two groups.Results In the treatment group,the operation time,indwelling time of catheter,the time of getting out of bed,and the hospitalization time was respectively(28.46±3.46)min,(2.31±0.42)d,(4.23±1.72)d,and(8.46±2.36)d.In the control group,the operation time,indwelling time of catheter,the time of getting out of bed,and the hospitalization time was respectively(30.46±3.85)min,(4.28±0.76)d,(8.56±1.87)d,and(14.86±2.74)d.There was no significant difference in the operation time between the two groups.The indwelling time of catheter,the time of getting out of bed and the time of hospitalization in the treatment group were significantly shorter than those in the control group(P<0.05).The incidence of complications in the treatment group was 2.5%,which was significantly lower than 20.0%in the control group(P<0.05).Conclusion Ureteroscopic holmium laser lithotripsy is simple and has fewer complications in patients with ureter and bladder calculi,and obviously shortened the catheter retention time,bed time and hospitalization time.It is more superior than extracorporeal shock wave lithotripsy and is worth popularizing.