输尿管软镜钬激光碎石术与微创经皮肾镜碎石术治疗2~3 cm肾结石的疗效分析

Ureteroscopic holmium laser lithotripsy and minimally invasive percutaneous nephrolithotripsy in the treatment of 2~3 cm renal calculi

目的:比较输尿管软镜钬激光碎石术与微创经皮肾镜碎石术治疗2~3 cm肾结石的疗效。方法:纳入2020年3月—2021年3月江西省赣州市于都县中医院接诊的肾结石患者80例,按照随机数字表对照法分为两组,每组40例。观察组行输尿管软镜钬激光碎石术治疗,对照组行微创经皮肾镜碎石术治疗。比较两组手术情况、术后情况、结石清除率、术后并发症情况以及手术前后肾功能指标变化。结果:观察组手术时间长于对照组,术中出血量、术后下床时间、术后住院时间均少于对照组,数据间对比差异有统计学意义(P<0.05)。观察组结石一次性清除率低于对照组,术后并发症总发生率低于对照组,数据间对比差异有统计学意义(P<0.05)。观察组手术后尿素氮(BUN)检测结果低于对照组(P<0.05)。结论:输尿管软镜钬激光碎石术与经皮肾碎石钬激光碎石相比较治疗2~3 cm肾结石的一次性清除率更低、手术时间更长,但手术创伤更小,术后恢复更快,并发症更少,肾脏损害更小,可根据实际情况进行选择。

Objective:To compare the efficacy of ureteroscopic holmium laser lithotripsy and minimally invasive percutaneous nephrolithotripsy in the treatment of 2~3 cm renal calculi.Methods:Eighty patients with renal calculi admitted to Traditional Chinese Medicine Hospital of Yudu County,Ganzhou City,Jiangxi Province from March 2020 to March 2021 were included,and divided into two groups with 40 cases in each group according to the random number table comparison method.The observation group received ureteroscopic holmium laser lithotripsy and the control group received minimally invasive percutaneous nephrolithotripsy.The operation condition,postoperative condition,stone clearance rate,postoperative complications and changes of renal function indexes before and after operation were compared between the two groups.Results:The operation time in the observation group was longer than that in the control group,and the amount of bleeding during operation,the time of getting out of bed after operation and the time of hospitalization after operation in the observation group were lower than those in the control group,and the difference between the data was statistically significant(P<0.05).The one-time stone clearance rate in the observation group was lower than that in the control group,and the total incidence of postoperative complications in the observation group was lower than that in the control group,and the difference between the data was statistically significant(P<0.05).The results of urea nitrogen in the observation group were lower than those in the control group(P<0.05).Conclusion:Compared with percutaneous renal lithotripsy holmium laser lithotripsy,ureteroscope holmium laser lithotripsy has a lower one-time clearance rate in the treatment of 2-3 cm renal calculi,and longer operation time,but it has less trauma,faster postoperative recovery,fewer complications and less renal damage,which can be selected according to the actual situation.