经输尿管镜钬激光碎石术与Cyberwand超声碎石术治疗输尿管结石的疗效对比

Comparative study on curative effect of ureteroscopic holmium laser lithotripsy and Cyberwand ultrasonic lithotripsy on ureteral calculi

目的比较经输尿管镜钬激光碎石术与Cyberwand超声碎石术治疗输尿管结石的疗效。方法输尿管结石患者80例,随机分为对照组和试验组各40例,对照组采用Cyberwand超声碎石术,试验组采用经输尿管镜钬激光碎石术,比较两组患者围手术期指标、肾功能指标、血清应激反应指标水平、术后结石残留率及并发症发生率。结果试验组患者的手术时间、术中出血量、住院时间均低于对照组(P<0.05);两组术后血尿素氮(BUN)、肌酐(Cr)、白细胞计数(WBC)、中性粒细胞计数(NEUT)、皮质醇(Cor)、肾上腺素(EP)水平及并发症发生率差异无显著性(P>0.05);试验组术后结石残留率低于对照组(P<0.05)。结论两种手术方式对输尿管结石患者肾功能指标、血清氧化应激指标的影响较小,经输尿管镜钬激光碎石术可显著降低患者手术时间、术中出血量、住院时间及术后结石残留率。

Aim To compare the efficacy of ureteroscopic holmium laser lithotripsy and Cyberwand ultrasonic lithotripsy on ureteral calculi.Methods Eighty patients with ureteral calculi were enrolled.They were divided into control group and experimental group with 40 cases in each group.The control group underwent Cyberwand ultrasonic lithotripsy,while experimental group underwent ureteroscopic holmium laser lithotripsy.The perioperative indexes,renal function indexes,levels of serum stress response indexes,postoperative stone residual rate and incidence of complications were compared between the two groups.Results After surgery,operation time,intraoperative blood loss and hospitalization time in experimental group were lower than those in control group(P<0.05).After surgery,there were no significant differences in levels of blood urea nitrogen(BUN)and creatinine(Cr),white blood cell count(WBC),neutrophil count(NEUT),cortisol(Cor)and epinephrine(EP)and complication rate between the two groups(P>0.05).The postoperative stone residual rate in experimental group was lower than that in control group(P<0.05).Conclusions The effects of the two surgical methods are few on renal function and serum oxidative stress indexes in patients with ureteral calculi.Compared with Cyberwand ultrasound lithotripsy,ureteroscopic holmium laser lithotripsy can significantly reduce operation time,intraoperative blood loss,hospitalization time and stone residual rate.