不同大小肾结石患者采用输尿管软镜下钬激光治疗的效果比较

Effect comparison of flexible ureteroscopic holmium laser in the treatment of different sizes of kidney stones

目的比较不同大小肾结石患者采用输尿管软镜下钬激光碎石术(FURS)治疗的临床效果。方法回顾性分析2018年1月~2019年9月我院收治的60例肾结石患者的临床资料,依据结石大小分为小结石组(结石直径≤2 cm)与大结石组(结石直径>2 cm),每组各30例,两组均予以FURS治疗。比较两组患者的手术指标、结石清除率、生活质量及术后并发症总发生率。结果两组患者的术中出血量与血红蛋白下降值比较,差异无统计学意义(P>0.05)。大结石组患者的手术用时、住院时间及术后排石时间长于小结石组,差异有统计学意义(P<0.05);两组患者的结石清除率及术后并发症总发生率比较,差异无统计学意义(P>0.05);术前及术后1个月,两组患者的生活质量综合评定问卷(GQOLI-74)评分比较,差异均无统计学意义(P>0.05);两组患者术后1个月的GQOLI-74评分均高于术前,差异有统计学意义(P<0.05)。结论FURS治疗对于直径>2 cm与≤2 cm的肾结石均有较高的结石清除率,并能显著提高患者的生活质量,具有安全、创伤小以及并发症较少等优势,且对小结石的治疗效果更好,安全性更高。

Objective To compare the clinical efficacy of flexible ureteroscopic holmium laser lithotripsy(FURS)in treatment of different sizes of kidney stones.Methods The clinical data of 60 patients with kidney stones who admitted in our hospital from January 2018 to September 2019 were retrospectively analyzed and divided into small stone group(stone diameter≤2 cm)and large stone group(stone diameter>2 cm)according to the size of the stones,with 30 cases in each group.The patients in two groups were treated with FURS.The surgical indexes,stone clearance rate,the quality of life and the incidence of postoperative complications were compared between the two groups.Results There were no statistically significant differences in the intraoperative bleeding volume and decreased value of hemoglobin between the two groups(P>0.05).The operation time,hospital stays time and postoperative removing stone time in large stone group were longer than those in small stone group,and the differences were statistically significant(P<0.05).There were no statistical differences in the stone clearance rate and the incidence of postoperative complications between the two groups(P>0.05).There was no statistically significant difference in the generic quality of life inventory(GQOLI-74)score before and 1 month after surgery between the two groups(P>0.05).The GQOLI-74 scores 1 month after surgery in two groups were higher than those before surgery,and the differences were statistically significant(P<0.05).Conclusion FURS in treatment of kidney stones>2 cm or≤2 cm has higher stone clearance rates,it can significantly increase quality of life of patients,and it has advantages of high safety,small trauma and less complications,which has better curative effects for small stones and higher safety.