输尿管软镜下钬激光碎石取石术治疗上尿路结石患者的效果

Effect of Holmium Laser Lithotripsy and Stone Extraction under Soft Ureteroscope in the Treatment of Patients with Upper Urinary Tract Calculi

目的:探讨输尿管软镜下钬激光碎石取石术治疗上尿路结石患者的效果。方法:选取宜兴市人民医院2020年3月-2021年3月收治的84例上尿路结石患者。按随机数字表法将其分为观察组(42例)和对照组(42例)。对照组给予输尿管硬镜取石术治疗,观察组给予输尿管软镜下钬激光碎石取石术。比较两组围手术期指标,术前和术后4个月生活质量,术前和术后7 d炎症因子及并发症。结果:观察组术后下床时间早于对照组,术中出血量少于对照组,手术时间短于对照组(P<0.05)。术后4个月,观察组生理功能、社会功能、角色限制、总体健康评分均高于对照组(P<0.05)。术后7 d,观察组PCT、IL-6、TNF-α、CRP水平均低于对照组(P<0.05)。术后7 d观察组并发症发生率低于对照组(P<0.05)。结论:输尿管软镜下钬激光碎石取石术治疗上尿路结石患者可有效缩短手术时间,减少术中出血量,减轻患者机体炎症反应,降低术后并发症发生率,促进术后恢复,且安全性较高。

Objective:To investigate the effect of holmium laser lithotripsy and stone extraction under soft ureteroscope in the treatment of patients with upper urinary tract calculi.Method:A total of 84 patients with upper urinary tract calculi treated in Yixing People’s Hospital from March 2020 to March 2021 were selected.They were divided into observation group(42 cases)and control group(42 cases)according to the random number table method.The control group was given the ureteroscopic lithotripsy,and the observation group was given the holmium laser lithotripsy and stone extraction under soft ureteroscope.The perioperative indexes,quality of life before and 4 months after surgery,inflammatory factors before and 7 days after surgery and complications were compared between the two groups.Result:The time of getting out of bed after surgery in the observation group was earlier than that in the control group,the amount of intraoperative bleeding was less than that in the control group,and the surgery time was shorter than that in the control group(P<0.05).Four months after surgery,the physiological function,social function,role limitation and overall health scores of the observation group were higher than those of the control group(P<0.05).Seven days after surgery,the levels of PCT,IL-6 and TNF-α,CRP in the observation group were lower than those in the control group(P<0.05).Seven days after surgery,the incidence of complications in the observation group was lower than that in the control group(P<0.05).Conclusion:Holmium laser lithotripsy and stone extraction under soft ureteroscope can effectively shorten the surgery time,reduce the amount of intraoperative bleeding,reduce the body inflammatory reaction of patients,reduce the incidence of postoperative complications,and promote postoperative recovery,with high safety.