输尿管软镜下钬激光碎石术治疗≥2 cm上尿路结石的临床效果

Clinical effect of flexible ureteroscopic holmium laser lithotripsy in the treatment of upper urinary calculi≥2 cm

目的探讨输尿管软镜(FURS)下钬激光碎石术治疗≥2 cm上尿路结石的临床效果。方法回顾性分析230例结石直径≥2 cm的上尿路结石患者的临床资料,根据治疗方案的不同将其分为对照组(n=115)与观察组(n=115)。对照组给予经皮肾镜碎石术(PCNL)治疗,观察组给予FURS下钬激光碎石术治疗。比较两组的临床效果。结果观察组的手术时间短于对照组,术中出血量少于对照组,术后VAS评分低于对照组(P<0.05)。术后1周,观察组的结石清除率低于对照组(P<0.05);术后1、3个月,两组的结石清除率比较,差异无统计学意义(P>0.05)。术后2 h,两组的CRP、PCT水平及WBC均升高,但观察组低于对照组(P<0.05)。观察组的并发症总发生率低于对照组(P<0.05)。结论FURS下钬激光碎石术治疗≥2 cm上尿路结石的效果显著,可缩短手术时间,减小创伤,降低并发症发生率。

Objective To explore the clinical effect of flexible ureteroscopic(FURS)holmium laser lithotripsy in the treatment of upper urinary calculi≥2 cm.Methods The clinical data of 230 patients with upper urinary calculi with diameter≥2 cm were retrospectively analyzed.The patients were divided into control group(n=115)and observation group(n=115)by different treatment schemes.The control group was treated with percutaneous nephrolithotomy(PCNL),and the observation group was treated with FURS holmium laser lithotripsy.The clinical effect of the two groups were compared.Results The operation duration in the observation group was shorter than that in the control group,the amount of intraoperative bleeding was less than that in the control group,and the postoperative VAS score was lower than that in the control group(P<0.05).One week after operation,the stone clearance rate in the observation group was lower than that in the control group(P<0.05);on 1 and 3 months,there were no significant differences in store clearance rate between the two groups(P>0.05).Two hours after operation,the levels of CRP,PCT and WBC in the two groups increased,but those in the observation group were lower than the control group(P<0.05).The total incidence of complications in the observation group was lower than that in the control group(P<0.05).Conclusion FURS holmium laser lithotripsy in the treatment of upper urinary calculi with diameter≥2 cm has significant effect,and it can shorten the operation duration,reduce trauma and decrease the incidence of complications.