经尿道输尿管软镜钬激光碎石取石治疗肾结石的效果

Efficacy of Transurethral Flexible Holmium Laser Lithotripsy in the Treatment of Kidney Stones

目的 分析在肾结石治疗中采取经尿道输尿管软镜钬激光碎石取石术治疗的临床效果。方法 选取2018年2月—2021年8月期间新沂市中医院收治的60例肾结石患者为研究对象,采取随机数表法分为两组。予以经皮肾镜碎石取石术治疗的16例纳入对照组,予以经尿道输尿管软镜钬激光碎石取石术治疗的44例纳入观察组。对比两组临床效果。结果 两组结石清除率分别为97.73%、93.75%,差异无统计学意义(P>0.05)。观察组术中出血量为(83.19±13.55)mL,低于对照组的(125.76±15.41)mL,手术时间、拔除导尿管时间以及住院时间为(80.20±3.44)min、(5.02±1.23)d、(10.26±1.02)d,均短于对照组的(140.92±13.48)min、(9.33±1.78)d、(14.57±1.21)d,差异有统计学意义(t=10.375、27.852、10.597、13.767,P<0.05)。术后,观察组BUA水平为(405.05±10.34)μmol/L,低于对照组的(426.52±11.66)μmol/L,Scr、Cys-C水平分别为(161.48±12.25)μmol/L、(655.37±34.25)μg/L,高于对照组的(139.51±13.42)μmol/L、(602.56±31.41)μg/L,差异有统计学意义(t=6.875、5.990、5.394,P<0.05)。观察组并发症发生率为2.27%,低于对照组的37.50%,差异有统计学意义(χ^(2)=10.917,P<0.05)。结论 在肾结石治疗中,采取经尿道输尿管软镜钬激光碎石取石术治疗效果明确,且肾功能损伤小,术后并发症少。

Objective To analyze the clinical effect of transurethral flexible holmium laser lithotripsy in the treatment of kidney stones.Methods A total of 60 patients with kidney stones admitted to Xinyi Hospital of Traditional Chinese Medicine from February 2018 to August 2021 were selected as the research objects. They were divided into two groups by the random number table method. The 16 cases treated with percutaneous nephrolithotomy were included in the control group, and the 44 cases treated with transurethral flexible endoscopic holmium laser lithotripsy were included in the observation group. The clinical effects of the two groups were compared.Results The stone clearance rates of the two groups were 97.73% and 93.75%, respectively, and the difference was not statistically significant(P>0.05). The intraoperative blood loss of the observation group was(83.19±13.55) mL, which was lower than that of the control group(125.76±15.41) mL, the operation time, catheter removal time and hospital stay were(80.20±3.44) min,(5.02±1.23) d,(10.26±1.02) d, all were shorter than the control group(140.92±13.48) min,(9.33±1.78) d,(14.57±1.21) d, and the difference was statistically significant(t=10.375, 27.852, 10.597, 13.767, P<0.05). After operation,the BUA level of the observation group was(405.05±10.34) μmol/L, which was lower than that of the control group(426.52±11.66) μmol/L, and the levels of Scr and Cys-C were(161.48±12.25) μmol/L,(655.37±34.25) μg/L, which were higher than the control group(139.51±13.42) μmol/L,(602.56±31.41) μg/L, the difference was statistically significant(t=6.875, 5.990, 5.394, P<0.05). The incidence of complications in the observation group was 2.27%, which was lower than 37.50% in the control group, and the difference was statistically significant(χ^(2)=10.917, P<0.05).Conclusion In the treatment of kidney stones, transurethral flexible holmium laser lithotripsy has a clear therapeutic effect, with less damage to renal function and fewer postoperative complications.