输尿管镜下钬激光碎石与传统开放手术治疗输尿管结石的对比观察

Comparative observation of ureteroscopic holmium laser lithotripsy and conventional open surgery in the treatment of ureteral calculi

目的分析输尿管镜下钬激光碎石和传统开放手术治疗输尿管结石的临床效果,为输尿管结石手术治疗提供参考。方法120例输尿管结石患者,按照入院顺序分为对照组与观察组,各60例。对照组采用开放手术治疗,观察组采用输尿管镜下钬激光碎石治疗。比较两组患者结石清除率、并发症发生率、手术相关指标(手术时间、术中出血量、术后住院时间)。结果观察组患者的结石清除率95.00%与对照组的90.00%比较,差异无统计学意义(P>0.05)。观察组并发症发生率5.00%低于对照组的25.00%,差异具有统计学意义(P<0.05)。观察组手术时间(42.30±5.50)min、术后住院时间(4.50±0.50)d均短于对照组的(80.50±7.50)min、(7.50±1.50)d,术中出血量(28.50±4.50)ml少于对照组的(61.50±6.50)ml,差异均具有统计学意义(P<0.05)。结论输尿管镜下钬激光碎石、传统开放手术治疗输尿管结石的结石清除效果接近,但输尿管镜下钬激光碎石术在手术损伤、患者恢复情况方面的优势更为突出,具有推行价值。

Objective To analyze the clinical effect of ureteroscopic holmium laser lithotripsy and conventional open surgery in the treatment of ureteral calculi,so as to provide reference for surgical treatment of ureteral calculi.Methods A total of 120 patients with ureteral calculi were divided into control group and observation group according to the order of admission,with 60 cases in each group.The control group was treated with open surgery,and the observation group was treated with ureteroscopic holmium laser lithotripsy.The stone clearance rate,incidence of complications,and surgery-related indicators(operation time,intraoperative blood loss,postoperative hospital stay)were compared between the two groups.Results The stone clearance rate of the observation group was 95.00%,and the difference was not statistically significant compared with 90.00%of the control group(P>0.05).The incidence of complications 5.00%in the observation group was lower than 25.00%in the control group,and the difference was statistically significant(P<0.05).The operation time(42.30±5.50)min and postoperative hospital stay(4.50±0.50)d in the observation group were shorter than(80.50±7.50)min and(7.50±1.50)d in the control group;the intraoperative blood loss(28.50±4.50)ml in the observation group was less than(61.50±6.50)ml in the control group;the differences were all statistically significant(P<0.05).Conclusion The effect of ureteroscopic holmium laser lithotripsy is close to that of conventional open surgery in the treatment of ureteral calculi,but ureteroscopic holmium laser lithotripsy has more prominent advantages in terms of surgical injury and patient recovery,and is of value for implementation.