侧卧位输尿管镜钬激光碎石在治疗输尿管上段结石的有效性及对手术时间、出血量、结石清除率的影响

Efficacy of lateral decubitus ureteroscopic holmium laser lithotripsy in the treatment of upper ureteral calculi and its influence on operation time,blood loss and calculus clearance rate

目的探讨侧卧位输尿管镜钬激光碎石对输尿管上段结石治疗的有效性及对手术时间、出血量、结石清除率的影响。方法回顾性分析2018年1月—2019年1月本院收治的90例输尿管上段结石患者的临床资料,按患者手术方式分为观察组(n=50)和对照组(n=40)两组。行常规气压弹道碎石的患者作为对照组,行输尿管镜钬激光碎石的患者作为观察组。比较两组患者手术时间、住院时间、手术出血量、结石清除率、治疗效果及术后并发症发生情况。结果观察组手术时间、住院时间、手术出血量均短(少)于对照组(P<0.05),观察组结石清除率(94.00%)高于对照组(85.00%)(P<0.05)。观察组治疗效果(98.00%)优于对照组(77.50%),差异有统计学意义(P<0.05)。两组患者术后均未出现输尿管穿孔、输尿管撕脱、输尿管断裂等严重并发症,观察组有1例出现发热,2例泌尿系统感染,对照组有2例出现发热,2例泌尿系统感染,两组数据有可比性(P>0.05)。结论对输尿管上段结石患者行侧卧位输尿管镜钬激光碎石可有效提高患者临床疗效,结石清除率较高,可进行临床推广应用。

Objective To investigate the efficacy of lateral decubeus ureteroscopic holmium laser lithotripsy(URL)in the treatment of upper ureteral calculi and its influence on the operative time,blood loss and calculus clearance rate.Methods The clinical data of 90 cases of patients with upper ureteral calculi those were admitted to our hospital from January 2018 to January 2019 were retrospectively analyzed.The patients were grouped according to the surgical methods.The control group received conventional pneumatic lithotripsy(n=40),and the observation group received ureteroscopic holmium laser lithotripsy(n=50).The operation time,hospital stay,surgical blood loss,stone clearance rate,treatment effect and postoperative complications were compared between the two groups.Results The operation time,hospital stay and blood loss in the observation group were much shorter or less than those in the control group(P<0.05),and the stone clearance rate in the observation group(94.00%)was higher than that in the control group(85.00%)(P<0.05).The treatment effect of observation group(98.00%)was better than that of control group(77.50%),and the difference was statistically significant(P<0.05).There were no serious complications such as ureteral perforation,ureteral avulsion and ureteral rupture in the two groups.There were 1 case of fever and 2 cases of urinary system infection in the observation group,and 2 cases of fever and 2 cases of urinary system infection in the control group,the data of the two groups were comparable(P<0.05).Conclusions Lateral decubeus ureteroscopic holmium laser lithotripsy could effectively improve the clinical efficacy of patients with upper ureteral calculi,and the calculus clearance rate is high,so it could be applied clinically.