输尿管镜钬激光碎石术治疗输尿管结石的效果及安全性

Efficacy and safety of ureteroscopic holmium laser lithotripsy in the treatment of ureteral calculi

目的探讨输尿管镜钬激光碎石术治疗输尿管结石的效果及安全性。方法选取2015年2月至2020年6月九江市第一人民医院泌尿外科收治的输尿管结石患者117例,按照治疗方式不同分为研究组(82例)和对照组(35例),对照组行开放手术,研究组行输尿管镜钬激光碎石术。比较两组治疗有效率、手术指标、并发症、结石排净率、炎症因子水平。结果研究组的治疗总有效率高于对照组,差异有统计学意义(P<0.05);研究组的手术、排气、下床活动的时间短于对照组,住院天数少于对照组,术中出血量少于对照组,差异有统计学意义(P<0.05);研究组的并发症总发生率低于对照组,差异有统计学意义(P<0.05)。两组的结石排净率比较,差异无统计学意义(P>0.05);研究组的炎症因子水平低于对照组,差异有统计学意义(P<0.05)。结论输尿管结石患者输尿管镜钬激光碎石术治疗效果显著,能改善患者手术指标,结石排净率也比较高,减少并发症的发生,降低患者炎症因子水平,应推广应用。

Objective To investigate the efficacy and safety of ureteroscopic holmium laser lithotripsy in the treatment of ureteral calculi.Methods A total of 117 patients with ureteral calculi admitted to the Department of Urology of Jiujiang First People′s Hospital from February 2015 to June 2020 were selected and divided into study group(n=82)and control group(n=35)according to different treatment methods.Thirty-five patients in the control group received open surgery,and eighty-two patients in the study group received ureteroscopic holmium laser lithotripsy.The effective rate of treatment,surgical indexes,complications,stone clearance rate and inflammatory factors were compared between the two groups.Results The total effective rate of the study group was higher than that of the control group,the difference was statistically significant(P<0.05).The time of operation,exhaust,getting out of bed activities and length of hospital stay in the study group were shorter than those in the control group,and the amount of surgical blood loss in the study group was less than that in the control group,the differences were statistically significant(P<0.05).The total incidence of complications in the study group was lower than that in the control group,and the difference was statistically significant(P<0.05).There was no statistically significant difference in stone clearance rate between the two groups(P>0.05).The levels of inflammatory cytokines in the study group were lower than those in the control group,and the difference was statistically significant(P<0.05).Conclusion The ureteroscopic holmium laser lithotripsy has a significant effect on patients with ureteral calculi,which can improve the surgical indicators of patients,and the stone clearance rate is relatively high.It can reduce the incidence of complications and the level of inflammatory factors in patients,and should be widely used.