输尿管软镜钬激光碎石术与经皮微创肾镜碎石术治疗输尿管上段结石的效果比较

Comparison between flexible ureteroscopic holmium laser lithotripsy and minimally invasive percutaneous nephrolithotripsy in the treatment of upper ureteral calculi

目的对比输尿管软镜钬激光碎石术与经皮微创肾镜碎石术治疗输尿管上段结石的效果。方法100例输尿管上段结石患者,按术式不同分为观察组与对照组,各50例。观察组以经皮微创肾镜碎石术治疗,对照组以输尿管软镜钬激光碎石术治疗,比较两组手术指标、结石清除情况、血红蛋白降低情况及并发症发生情况。结果观察组手术时间(98.34±7.61)min短于对照组的(153.26±12.71)min,住院时间(6.27±1.02)d长于对照组的(3.75±1.28)d,差异均具有统计学意义(P<0.05)。观察组一期手术结石清除率98.00%、血红蛋白下降值(1.72±0.43)g/L高于对照组的82.00%、(0.49±0.22)g/L,差异均具有统计学意义(P<0.05)。结论输尿管软镜钬激光碎石术与经皮微创肾镜碎石术治疗输尿管上段结石均有良好效果,虽经皮微创肾镜碎石术创伤较大,但其手术时间短,结石清除率更高,临床需根据具体情况酌情选择手术方案。

Objective To compare the effect of flexible ureteroscopic holmium laser lithotripsy and minimally invasive percutaneous nephrolithotripsy in the treatment of upper ureteral calculi.Methods A total of 100 patients with upper ureteral calculi were divided into observation group and control group according to different surgical methods,with 50 cases in each group.The observation group was treated with minimally invasive percutaneous nephrolithotripsy,and the control group was treated with flexible ureteroscopic holmium laser lithotripsy.The surgical indicators,calculi clearance,hemoglobin reduction and occurrence of complications were compared between the two groups.Results The operation time(98.34±7.61)min of the observation group was shorter than(153.26±12.71)min of the control group,and hospitalization time(6.27±1.02)d was longer than(3.75±1.28)d of the control group,and the difference was statistically significant(P<0.05).The calculi clearance rate of firs-stage operation 98.00% and the hemoglobin reduction value(1.72±0.43)g/L was higher than 82.00%and(0.49±0.22)g/L of the control group,and the difference was statistically significant(P<0.05).Conclusion Both flexible ureteroscopic holmium laser lithotripsy and minimally invasive percutaneous nephrolithotripsy have good effect in the treatment of upper ureteral calculi.Although minimally invasive percutaneous nephrolithotripsy is traumatic,its operation time is short and the calculi clearance rate is higher.Therefore,it is necessary to choose the operation plan according to the specific situation.