经尿道电切镜下钬激光碎石术治疗膀胱结石患者的效果

Effects of Holmium YAG laser lithotripsy by transurethral electroscope in the treatment of bladder stones

目的:探讨经尿道电切镜下钬激光碎石术(HL)治疗膀胱结石患者的效果。方法:选取2019年6月至2021年2月该院收治的68例膀胱结石患者进行前瞻性研究,按随机数字表法分为对照组(n=34)和研究组(n=34)。对照组采用经皮肾镜气压弹道碎石术(PL)治疗,研究组采用经尿道电切镜下HL治疗。比较两组术前和术后3个月尿道功能指标[最大尿流率(Qmax)、残余尿量(RUV)]水平,术中出血量,碎石时间,术前和术后1、3 d氧化应激指标[谷胱甘肽过氧化物酶(GSH-Px)、过氧化氢酶(CAT)、超氧化物歧化酶(SOD)、丙二醛(MDA)]水平,以及并发症发生率。结果:术后3个月,两组Qmax水平均高于术前,且研究组高于对照组,两组RUV水平均低于术前,且研究组低于对照组,差异有统计学意义(P<0.05);研究组术中出血量少于对照组,碎石时间短于对照组,差异均有统计学意义(P<0.05);术后1、3 d,两组血清GSH-Px、CAT、SOD水平均低于术前,但研究组高于对照组,两组MDA水平均高于术前,但研究组低于对照组,差异有统计学意义(P<0.05);研究组并发症发生率低于对照组,差异有统计学意义(P<0.05)。结论:经尿道电切镜下HL治疗膀胱结石患者可改善尿道功能指标和氧化应激指标水平,减少术中出血量,缩短碎石时间,降低并发症发生率,效果优于经皮肾镜PL治疗。

Objective: To explore effects of Holmium YAG laser lithotripsy(HL) by transurethral electroscope in the treatment of bladder stones. Methods: A prospective study was conducted on 68 patients with bladder stones admitted to the hospital from June 2019 to February 2021. They were divided into control group(n=34) and study group(n=34) according to the random number table method. The control group was treated with pneumatic ballistic lithotripsy(PL), while the study group was treated with HL. The levels of urethral function indexes [maximum urinary flow rate(Qmax), residual urine volume(RUV)], the operation-related index levels(intraoperative blood loss, lithotripsy time), the oxidative stress index levels [glutathione peroxidase(GSH-Px), catalase(CAT), superoxide dismutase(SOD), malondialdehyde(MDA)], and the incidence of complications were compared between the two groups before and 3 months after the surgery. Results: 3 months after the surgery, the Qmax levels of the two groups were higher than those before the surgery, that in the study group was higher than that in the control group;the RUV levels of the two groups were lower than those before the surgery, and that in the study group was lower than that in the control group;and the differences were statistically significant(P<0.05).The amount of bleeding in the study group was less than that in the control group, the lithotripsy time was shorter than that in the control group, and the differences were statistically significant(P<0.05). 1 and 3 days after the surgery, the levels of serum GSH-Px, CAT and SOD in the two groups were lower than those before the surgery, but those in the study group were higher than those in the control group;the MDA levels of the two groups were higher than those before the surgery, but the study group was lower than the control group;and the difference was statistically significant(P<0.05).Further, the incidence of complications in the study group was lower than that in the control group, and the difference was statistically significant(P<0.05). Conclusions: HL in the treatment of bladder stones can improve the levels of urethral function indexes and the oxidative stress indexes,reduce intraoperative blood loss, shorten the lithotripsy time, and reduce the incidence of complications. Moreover, it is superior to PL treatment.