输尿管镜钬激光碎石治疗嵌顿性输尿管结石的疗效分析

Efficacy analysis of ureteroscopic holmium laser lithotripsy in the treatment of impacted ureteral calculi

目的探究输尿管镜钬激光碎石治疗嵌顿性输尿管结石的临床疗效。方法82例嵌顿性输尿管结石患者作为研究对象,以双色球法分为对照组与观察组,每组41例。对照组采取气压弹道碎石术治疗,观察组采取输尿管镜钬激光碎石术治疗。对比两组患者临床相关指标,治疗前后肾功能指标[尿素氮(BUN)、肌酐(Cr)],并发症发生情况,复发情况。结果观察组手术时间(78.16±2.49)min、下床活动时间(12.15±1.39)h、住院时间(7.61±1.20)d均短于对照组的(98.93±2.68)min、(18.30±1.45)h、(9.98±1.25)d,术中出血量(48.80±2.48)ml少于对照组的(67.81±2.70)ml,差异均有统计学意义(P<0.05)。治疗后,观察组BUN、Cr水平分别为(4.45±0.12)mmol/L、(101.29±2.49)μmol/L,均低于对照组的(7.13±0.43)mmol/L、(112.40±2.56)μmol/L,差异均有统计学意义(P<0.05)。观察组并发症发生率7.32%低于对照组的26.83%,差异有统计学意义(P<0.05)。随访6个月,两组复发率对比,差异无统计学意义(P>0.05)。结论对嵌顿性输尿管结石患者采取输尿管镜钬激光碎石治疗可明显改善肾功能,并降低患者术后并发症发生率,同时该手术具有较高的安全性,建议推广。

Objective To investigate the clinical efficacy of ureteroscopic holmium laser lithotripsy in the treatment of impacted ureteral calculi.Methods A total of 82 patients with impacted ureteral calculi were selected as the research subjects,and were divided into the control group and the observation group by the twocolor ball method,with 41 cases in each group.The control group was treated with pneumatic ballistic lithotripsy,and the observation group was treated with ureteroscopic holmium laser lithotripsy.The clinical related indicators,renal function indicators[blood urea nitrogen(BUN),creatinine(Cr)]before and after treatment,complications,and recurrence were compared between the two groups.Results The operation time(78.16±2.49)min,off-bed activity time(12.15±1.39)h,and hospital stay(7.61±1.20)d of the observation group were shorter than(98.93±2.68)min,(18.30±1.45)h,and(9.98±1.25)d of the control group;the intraoperative blood loss(48.80±2.48)ml of the observation group was less than(67.81±2.70)ml of the control group;all the differences were statistically significant(P<0.05).After treatment,the levels of BUN and Cr in the observation group were(4.45±0.12)mmol/L and(101.29±2.49)μmol/L,which were lower than(7.13±0.43)mmol/L and(112.40±2.56)μmol/L in the control group,and the differences were statistically significant(P<0.05).The incidence of complications 7.32%in the observation group was lower than 26.83%in the control group,and the difference was statistically significant(P<0.05).After 6 months of follow-up,there was no statistically significant difference in the recurrence rate between the two groups(P>0.05).Conclusion Ureteroscopic holmium laser lithotripsy for patients with impacted ureteral calculi can obviously improve renal function and postoperative complication rate of patients,and the procedure has high safety,which can be promoted.