输尿管软镜钬激光碎石术与经皮肾镜碎石取石术治疗肾结石患者的效果比较

Comparison of effects of flexible ureteroscope Holmium laser lithotripsy and percutaneous nephrolithotomy in treatment of kidney stones

目的:比较输尿管软镜钬激光碎石术与经皮肾镜碎石取石术治疗肾结石患者的效果。方法:回顾性分析2020年10月至2021年10月该院收治的80例肾结石患者的临床资料,按照手术方法不同分为对照组和观察组各40例。对照组采用经皮肾镜碎石取石术治疗,观察组采用输尿管软镜钬激光碎石术治疗,比较两组临床疗效、手术相关指标(手术时间、术中出血量、住院时间)水平、一次性碎石成功率、手术前后炎性指标[白细胞介素-10(IL-10)、C反应蛋白(CRP)、白细胞计数(WBC)]水平、肾功能指标[血肌酐(Scr)、血尿素氮(BUN)、中性粒细胞明胶酶相关脂质运载蛋白(NGAL)]水平,以及并发症发生率。结果:观察组一次性碎石成功率为72.50%(29/40),低于对照组的92.50%(37/40),差异有统计学意义(P<0.05);两组治疗总有效率比较,差异无统计学意义(P>0.05);治疗后,观察组IL-10、CRP、WBC、Scr、BUN、NGAL水平均低于对照组,手术时间长于对照组,术中出血量少于对照组,住院时间短于对照组,差异有统计学意义(P<0.05);两组并发症发生率比较,差异无统计学意义(P>0.05)。结论:经皮肾镜碎石取石术和输尿管钬激光碎石术治疗肾结石患者的远期效果相当,输尿管软镜钬激光碎石术一次性碎石成功率较低,但可减少术中出血量,缩短住院时间,临床治疗时应该根据患者自身实际情况,为其选择最合适的治疗方案。

Objective:To compare effects of flexible ureteroscope Holmium laser lithotripsy and percutaneous nephrolithotomy in treatment of kidney stones.Methods:The clinical data of 80 patients with kidney stones admitted to this hospital from October 2020 to October 2021 were retrospectively analyzed,and they were divided into control group and observation group according to the random number table method,40 cases in each.The control group was treated with percutaneous nephrolithotomy,while the observation group was treated with flexible ureteroscope Holmium laser lithotripsy.The clinical efficacy,the operation-related indicator levels(operation time,intraoperative blood loss,hospitalization time),the one-time lithotripsy success rate,the inflammatory indicator levels[interleukin-10(IL-10),C-reactive protein(CRP),white blood cell count(WBC)]before and after the surgery,the renal function indicator levels[serum creatinine(Scr),blood urea nitrogen(BUN),neutrophil gelatinaseassociated lipocalin(NGAL)],and the incidence of complications were compared between the two groups.Results:The one-time lithotripsy success rate in the observation group was 72.50%(29/40),which was lower than 92.50%(37/40)in the control group,and the difference was statistically significant(P<0.05).There was no significant difference in the total effective rate between the two groups(P>0.05).The levels of IL-10,CRP,WBC,Scr,BUN and NGAL in the observation group were lower than those in the control group;the operation time was longer than that in the control group;the intraoperative blood loss was less than that in the control group;the hospitalization time was shorter than that in the control group;and the differences were statistically significant(P<0.05).However,there was no significant difference in the incidence of complications between the two groups(P>0.05).Conclusions:Percutaneous nephrolithotomy and flexible ureteroscope Holmium laser lithotripsy have comparable long-term outcomes in the treatment of kidney stones.Flexible ureteroscope Holmium laser lithotripsy has a low one-time lithotripsy success rate,but it can reduce the intraoperative blood loss and shorten the hospitalization time.Therefore,the most appropriate treatment plan should be selected according to the actual situation of the patient clinically.