输尿管软镜钬激光碎石术治疗肾结石的有效性及对生存质量的影响

The Effectiveness of Flexible Ureteroscopic Holmium Laser Lithotripsy in the Treatment of Kidney Stones and Its Effect on the Quality of Life

目的:探讨输尿管软镜钬激光碎石术治疗肾结石的有效性及对生存质量的影响。方法:选2018年4月-2020年4月收治的肾结石患者186例,随机分为两组,对照组实施经皮肾镜取石术治疗,研究组实施输尿管软镜钬激光碎石术,比较两组手术指标(手术或住院的时间、出血量)、结石清除率、炎症因子水平、并发症和QOL评分(生存质量)情况。结果:对照组的手术时间稍短于研究组,结石<20 mm时,对照组的结石清除率比研究组低,结石≥20 mm时,对照组的结石清除率比研究组高,但对照组住院时间长于研究组,术中的出血量多于研究组(P<0.05),对照组的炎症因子水平高于研究组(P<0.05),对照组并发症发生率高于研究组(P<0.05),对照组QOL评分低于研究组(P<0.05)。结论:肾结石患者临床治疗中采取输尿管软镜钬激光碎石术治疗效果显著,手术的时间比标准通道手术的时间略长,但是能显著减少患者住院的时间和出血量,还能改善患者的炎症因子水平和生存质量,使临床结石清除率得到改善,并能降低患者患并发症的风险,应推广应用。

Objective:To evaluate the effectiveness of flexible ureteroscopic holmium laser lithotripsy in the treatment of kidney stones and its effect on the quality of life.Method:A total of 186 kidney stone patients admitted from April 2018 to April 2020 were randomly divided into two groups.The control group underwent percutaneous nephrolithotomy and the study group underwent flexible ureteroscopic holmium laser lithotripsy.The two groups were compared in terms of surgical indicators (duration of operation or hospitalization,amount of blood loss),stone clearance rate,inflammatory factor level,complications and QOL score (quality of life).Result:Operation time in the control group was slightly lower than that in the study group,when stones <20 mm,the stone clearance rate of the control group was lower than that of the study group,when stones ≥20 mm,the stone clearance rate of the control group was higher than that of the study group,but the length of hospital stay and perioperative blood loss in the study group were better than those in the control group (P<0.05).Inflammatory factor levels in the control group were higher than those in the study group (P<0.05).The complication rate of control group was higher than that of the study group (P<0.05),and QOL score of control group was lower than that of the study group (P<0.05).Conclusion:In clinical treatment of patients with renal stones take flexible ureteroscopic holmium laser lithotripsy treatment effect is remarkable,the time of surgery time slightly longer than standard channel operation,but can significantly reduce the in-hospital time and blood loss,also can improve the patients’ level of inflammatory factors and quality of life,improve clinical calculi clearance rate,and can reduce the risk of complications,patients with should be applied.