输尿管镜钬激光碎石术治疗老年输尿管结石的效果

Effect of ureteroscopic holmium laser lithotripsy in the treatment of elderly ureteral stones

目的探讨输尿管镜钬激光碎石术治疗老年输尿管结石的效果及对肾功能的影响。方法选择2021年1月-2022年12月我院收治的老年输尿管结石患者30例,均接受输尿管镜钬激光碎石术治疗,观察手术碎石效果、手术指标、并发症以及术后1个月的结石排出情况;检测手术前后血肌酐、尿素氮指标,评估其肾功能。结果患者全部碎石成功,成功率为100.00%,术后1个月的结石排净率为100.00%;手术时间为(41.54±5.56)min、术中出血量为(15.34±2.38)ml、住院时间(3.63±1.04)d;术后血肌酐、尿素氮水平为(98.42±12.35)μmol/L、(4.35±1.11)mmol/L,均显著低于术前(P<0.05)。30例患者出现1例发热,经物理降温、抗感染等处理后退热;1例血尿,经止血处理后恢复正常;另1例腰部轻微疼痛,未经特殊处理自行缓解。结论在老年输尿管结石患者治疗中采用输尿管镜钬激光碎石术,可取得理想的碎石效果与结石排净效果,且对老年患者肾功能影响小。

Objective To investigate the effectiveness of ureteroscopic holmium laser lithotripsy in the treatment of elderly ureteral stones and its impact on renal function.Methods 30 elderly patients with ureteral calculi admitted to our hospital from January 2021 to December 2022 were selected.All the patients were treated with ureteroscopic holmium laserlithotripsy.The effectof lithotripsy,surgical indicators,complications and stone dischargeone month after surgery were observed.The blood creatinine and urea nitrogen indicators of the patients before and after surgery were measured to evaluate their renal function.Results All the enrolled patients were successfully treated with lithotripsy,with a success rate of 100.00%.The stone clearance rate one month after surgery was 100.00%.The surgical time was(41.54±5.56)minutes,intraoperative bleeding was(15.34±2.38)ml,and hospitalization time was(3.63±1.04)days.Postoperative serum creatinine and urea nitrogen levels were(98.42±12.35)μmol/L and(4.35±1.11)mmol/L,were significantly lower than before surgery(P<0.05).In terms of complications,one of the 30 patients experienced fever,which was relieved after physical cooling and anti infection treatment.One case of hematuria returned to normal after hemostasis treatment.Another case of mild pain in the lower back was relieved without special treatment.Conclusion The use of ureteroscopic holmium laser lithotripsy in the treatment of elderly patients with ureteral calculi can achieve ideal lithotripsy and stone clearance effects,with minimal impact on renal function in elderly patients.