经输尿管镜钬激光术治疗尿道狭窄合并膀胱结石的临床效果观察

Observation on clinical effect of holmium laser ureteroscopy in the treatment of urethral stricture with vesical calculus

目的观察经输尿管镜钬激光术治疗尿道狭窄合并膀胱结石的临床效果。方法 64例尿道狭窄合并膀胱结石患者,根据随机数字表法分为对照组和试验组,每组32例。对照组患者采用电切镜冷刀术治疗,观察组患者采用经输尿管镜钬激光术治疗。比较两组患者围手术期指标、临床治疗效果、治疗前后世界卫生组织生存质量测定量表(WHOQOL-100)评分。结果观察组患者碎石时间(20.05±1.26)min、手术时间(33.73±4.17)min、住院时间(7.53±0.77)d均短于对照组的(41.35±3.74)min、(52.66±6.28)min、(12.69±1.08)d,术中出血量(11.75±0.67)ml少于对照组的(21.03±1.27)ml,差异具有统计学意义(P<0.05)。治疗后,观察组总有效率为96.88%,高于对照组的78.13%,差异具有统计学意义(P<0.05)。治疗前,两组生理、心理、社会、环境、独立、精神世界/宗教/个人信仰评分比较,差异无统计学意义(P>0.05);治疗后,两组生理、心理、社会、环境、独立、精神世界/宗教/个人信仰评分均较治疗前明显升高,且观察组高于对照组,差异具有统计学意义(P<0.05)。结论经输尿管镜钬激光术治疗尿道狭窄合并膀胱结石患者,可明显缩短碎石、手术及住院时间,减少术中出血量,提升临床疗效,有效提升患者生活质量,效果理想。

Objective To observe the clinical effect of holmium laser ureteroscopy in the treatment of urethral stricture with vesical calculus. Methods A total of 64 patients with urethral stricture and vesical calculus were divided into control group and experimental group according to random numerical table, with 32 cases in each group. The control group was treated with resectoscopic cryosurgery, and the observation group was treated with holmium laser ureteroscopy. The perioperative indicators, clinical effect, World Health Organisation quality of life questionnaire(WHOQOL-100) score before and after treatment were compared between the two groups. Results The lithotripsy time(20.05±1.26) min, operation time(33.73±4.17) min and hospitalization time(7.53±0.77) d of the observation group were shorter than(41.35±3.74) min,(52.66±6.28) min and(12.69±1.08) d, and intraoperative blood loss(11.75±0.67) ml was less than(21.03±1.27) ml of the control group. All the difference was statistically significant(P<0.05). After treatment, the total effective rate of the observation group was 96.88%, which was higher than 78.13% of the control group, and the difference was statistically significant(P<0.05). Before treatment, there was no statistically significant difference in physical, psychological, social, environmental, independent, spiritual world/religious/personal belief score between the two groups(P>0.05). After treatment, the physical, psychological, social, environment, independent, spiritual world/religious/personal belief of the two groups were obviously higher than those before treatment, and the observation group was higher than the control group, and the difference was statistically significant(P<0.05). Conclusion Holmium laser ureteroscopy shows ideal effect in the treatment of patients with urethral stricture and vesical calculus, which can obviously shorten lithotripsy time, operation time and hospitalization time, reduce intraoperative blood loss, and improve clinical efficacy and quality of life of patients.