输尿管软镜钬激光碎石术治疗4cm内单发肾结石的疗效及血Cys-C的影响

Effect of Soft Ureteroscopic Holmium Laser Lithotripsy in the Treatment of Single Kidney Stone within 4cm and the Influence of Blood Cys-C

目的:探究输尿管软镜钬激光碎石术治疗4cm内单发肾结石的疗效及血Cys-C的影响。方法:收集2016年3月—2021年3月期间来我院接受手术治疗的4cm内单发肾结石患者102例,据手术方式不同分为两组,观察组与对照组,各51例。对照组以经皮肾镜取石术治疗,观察组以输尿管软镜钬激光碎石术治疗,比对两组各手术相关指标,手术前后血清学指标(Cys-C、Kim-1)水平、并发症发生率。结果:观察组手术时间、一期结石清除率均高于对照组,但术中出血量、住院时间、并发症发生率均低于对照组(P<0.05);术后血清Cys-C与Kim-1水平观察组低于对照组(P<0.05)。结论:4cm内单发肾结石经输尿管软镜钬激光碎石术治疗的结石清除率、安全性高于经皮肾镜取石术,虽手术时间长,但术中出血量低,利于康复,且对肾功能Cys-C、Kim-1的影响小,值得推广。

Objective:To investigate the effect of soft ureteroscopic holmium laser lithotripsy in the treatment of single kidney stone within 4cm and the influence of blood Cys-C.Methods:102 patients with single kidney stone within 4cm who received surgical treatment in our hospital from March 2016 to March 2021 were collected and divided into two groups according to different surgical methods,observation group and control group,51 cases in each group.The control group was treated with percutaneous nephrolithotomy,and the observation group was treated with soft ureteroscopic holmium laser lithotripsy.The related indexes,serum indexes(Cys-C,KIM-1)and incidence of complications before and after surgery were compared between the two groups.Results:The operation time and primary stone clearance rate in the observation group were higher than those in the control group,but the amount of intraoperative blood loss,length of hospital stay and complication rate were lower than those in the control group(P<0.05).The levels of serum Cys-C and KIM-1 in the observation group were lower than those in the control group(P<0.05).Conclusion:soft ureteroscopic holmium laser lithotripsy for single kidney stones within 4cm has higher stone clearance rate and safety than percutaneous nephrolithotomy.Although the operation time is long,the intraoperative blood loss is low,which is conducive to rehabilitation,and has little influence on renal function Cys-C and KIM-1,which is worthy of promotion.