镍钛合金泌尿系统取石网联合钬激光碎石术与传统体外碎石的疗效比较

Comparison of therapeutic effect of Nitinol alloy urinary lithotripsy mesh combined with holmium laser lithotripsy and conventional extracorporeal lithotripsy

目的比较镍钛合金泌尿系统取石网联合钬激光碎石术与传统体外碎石的治疗效果。方法选取2019年12月至2020年12月在本院收治的120例输尿管结石患者的临床资料,按照随机数字表法将其分为联合组和传统组,每组60例。联合组采用镍钛合金泌尿系统取石网联合钬激光碎石术治疗,传统组采用传统体外碎石治疗。对两组患者的围手术期指标、结石排净效果、血清指标以及并发症发生情况进行比较。结果联合组患者的总手术时间、结石长径>1 cm和≤1 cm的手术时间、住院时间、术后血尿持续时间均短于传统组,差异均有统计学意义(均P<0.05)。联合组患者的结石长径>1 cm、上段、中下段结石排净率均高于传统组(均P<0.05)。治疗前,两组患者的血肌酐(Scr)、24 h尿微量白蛋白(ALB)水平比较,差异均无统计学意义(均P>0.05)。两组患者治疗后的Scr、ALB水平较治疗前明显上升,且治疗后联合组的Scr、ALB水平低于传统组,差异均有统计学意义(均P<0.05)。联合组的并发症发生率[5例(8.33%)]低于传统组[11例(18.33%)],差异有统计学意义(P<0.05)。结论与传统体外碎石治疗相比,镍钛合金泌尿系统取石网联合钬激光碎石术的治疗效果更明显,尤其是对结石长径>1 cm患者的碎石排净率更高,且并发症风险低,安全性高。

Objective To investigate the therapeutic effect of nickel titanium alloy urinary system lithotripsy combined with holmium laser lithotripsy and traditional extracorporeal lithotripsy.Methods The clinical data of 120 patients with ureteral calculi admitted to our hospital from December 2019 to December 2020 were selected and divided into the combined group and the traditional group according to the random number table method,with 60 patients in each group.The combined group was treated with nickel titanium alloy urinary system lithotripsy combined with holmium laser lithotripsy,while the traditional group was treated with traditional extracorporeal lithotripsy.The perioperative indexes,stone removal effect,serum indexes and complications of the two groups were compared.Results The total operation time,operation time with stone diameter>1 cm and≤1 cm,hospital stay and postoperative hematuria duration in combination group were all shorter than those in traditional group,with statistical significance(all P<0.05).In combination group,the calculi diameter>1 cm,and the removal rate of calculi in upper and middle and lower segments were higher than those in traditional group(all P<0.05).Before treatment,there were no significant differences in serum creatinine(Scr)and 24 h urinary microalbumin(ALB)levels between two groups(all P>0.05).The Scr and ALB levels in the two groups after treatment were significantly higher than those before treatment,Scr and ALB levels in the combined group were less than than in the traditional group,and the difference was statistically significant(all P<0.05).The complication rate in the combined group[5 cases(8.33%)]was lower than that in the traditional group[11 cases(18.33%)],with a statistically significant difference(P<0.05).Conclusions Compared with the traditional extracorporeal lithotripsy,the nickel titanium alloy urinary system lithotripsy combined with holmium laser lithotripsy is more effective,especially for patients with a stone diameter greater than 1 cm,with a higher stone removal rate,low risk of complications and high safety.