输尿管下段结石钬激光碎石开展日间手术的优势与体会

Advantages and experience of holmium laser lithotripsy in lower ureteral calculi as day operation

总结输尿管下段结石钬激光碎石作为日间手术的优势与体会。选取2019年11月—2020年10月行钬激光碎石+支架管置入术治疗输尿管下段结石患者50例,将患者随机纳入日间手术组与常规手术组,日间手术组利用日间手术运行模式实施输尿管镜下钬激光碎石术,常规手术组利用传统住院模式实施输尿管镜下钬激光碎石术,比较2组术前等待时间、住院时间、结石清除率、术后并发症和住院费用等指标。日间手术组术前等待时间明显少于常规手术组[(27±6)h vs.(72±11)h,P<0.05]。日间手术组住院时间明显少于常规手术组[(38±9)h vs.(96±25)h,P<0.05]。日间手术组住院费用明显低于常规手术组[(10443±1302)元vs.(16523±2347)元,P<0.05]。2组结石清除率(91.4%vs.91.8%,P>0.05)和术后并发症发生率(4.3%vs.0,P>0.05)比较差异无统计学意义,在手术安全性及治疗效果方面无差异,皆安全可行。输尿管下段结石钬激光碎石开展日间手术安全可行,具有住院时间短、医疗费用低、治疗效果确切等优点,是一种高效安全的治疗模式,值得积极推广。

To summarize the advantages and experience of holmium laser lithotripsy in lower ureteral calculi as Day Operation.A total of 50patients with lower ureteral calculi treated in our hospital from November 2019to October 2020were randomly divided into Day Operation group and routine operation group.The Day Operation group was treated with holmium laser lithotripsy under ureteroscope,while the routine operation group was treated with holmium laser lithotripsy under ureteroscope by traditional hospitalization mode.s:The waiting time before operation of Day Operation group was significantly shorter than that of the routine group[(27±6)h vs.(72±11)h,P<0.05].The length of hospital stay in Day Operation group was significantly shorter than that in routine group[(38±9)h vs.(96±25)h,P<0.05].Hospitalization cost of Day Operation group was significantly lower than that of routine operation group[(10443±1302)yuan vs.(16523±2347)yuan,P<0.05].However,there was no significant difference in stone clearance rate(91.4%vs.91.8%,P>0.05)or postoperative complication rate(4.3%vs.0,P>0.05)between the two groups.Also,there was no difference in surgical safety or therapeutic effect,so both treatment modes were safe and feasible.Holmium laser lithotripsy for lower ureteral calculi as Day Operation is safe and feasible,and has the advantages of short hospitalization time,low medical expenses and accurate treatment effect.It is an efficient and safe treatment mode,so it is worthy of active promotion.