输尿管软镜联合钬激光碎石术治疗上尿路结石的临床疗效研究

Study on clinical efficacy of flexible ureteroscope combined with holmium laser lithotripsy in the treatment of upper urinary calculi

目的分析上路尿结石采取输尿管软镜联合钬激光碎石术治疗的临床效果。方法120例上尿路结石患者,按照随机数字表法将所有患者分为对照组和观察组,每组60例。对照组采取经皮肾镜碎石,观察组患者采取输尿管软镜联合钬激光碎石。比较两组患者术中出血量、手术时间、住院时间、结石清除率、治疗效果。结果观察组患者术中出血量(15.35±6.84)ml少于对照组的(28.45±4.57)ml,手术时间(79.32±1.37)min、住院时间(7.54±1.41)d均短于对照组的(90.36±7.94)min、(12.43±2.85)d,差异具有统计学意义(P<0.05)。观察组患者结石清除率为90.00%(54/60),高于对照组的75.00%(45/60),差异具有统计学意义(χ^(2)=4.675,P=0.031<0.05)。观察组治疗总有效率91.67%高于对照组的78.33%,差异具有统计学意义(P<0.05)。结论使用输尿管软镜联合钬激光碎石术治疗上尿路结石可以提升治疗效果及结石清除率,减少术中出血量,缩短手术时间、住院时间,值得推广。

Objective To analyze the clinical effect of flexible ureteroscope combined with holmium laser lithotripsy in the treatment of upper urinary calculi.Methods A total of 120 patients with upper urinary calculi were randomly divided into control group and observation group,with 60 cases in each group.The control group was treated with percutaneous nephrolithotripsy,and the observation group was treated with flexible ureteroscope combined with holmium laser lithotripsy.The intraoperative blood loss,operation time,hospitalization time,stone clearance rate and therapeutic effect were compared between the two groups.Results The intraoperative blood loss(15.35±6.84)ml of the observation group was less than(28.45±4.57)ml of the control group;the operation time(79.32±1.37)min and the hospitalization time(7.54±1.41)d of the observation group were shorter than(90.36±7.94)min and(12.43±2.85)d of the control group;all the differences were statistically significant(P<0.05).The stone clearance rate in the observation group was 90.00%(54/60),which was higher than 75.00%(45/60)in the control group,and the difference was statistically significant(χ^(2)=4.675,P=0.031<0.05).The total effective rate 91.67% of the observation group was higher than 78.33% of the control group,and the difference was statistically significant(P<0.05).Conclusion Flexible ureteroscope combined with holmium laser lithotripsy in the treatment of urinary calculi can improve the therapeutic effect and stone clearance rate,reduce intraoperative blood loss,shorten operation time and hospitalization time,which is worthy of promotion.