同期输尿管软镜钬激光碎石术治疗直径<2cm双侧上尿路结石的临床效果

Clinical Effect of Simultaneous Flexible Ureteroscope Holmium Laser Lithotripsy in the Treatment of Bilateral Upper Urinary Tract Stones with<2 cm in Diameter

目的:观察同期输尿管软镜钬激光碎石术治疗直径<2 cm双侧上尿路结石的临床效果。方法:选取2021年2月-2023年4月高州市人民医院收治的96例直径<2 cm双侧上尿路结石患者。随机将其分为观察组和体外冲击波碎石术(ESWL)组,各48例。ESWL组采用同期ESWL治疗,观察组采用同期输尿管软镜钬激光碎石术治疗。比较两组治疗效果,术后1 d、3 d疼痛情况,术前、术后3 d应激指标及并发症。结果:观察组结石取净率高于ESWL组,结石残留率低于ESWL组,差异有统计学意义(P<0.05)。术后1 d、3 d,观察组视觉模拟评分法(VAS)评分低于ESWL组,差异有统计学意义(P<0.05)。术后3 d,观察组促肾上腺皮质激素(ACTH)、C反应蛋白(CRP)水平均低于ESWL组,差异有统计学意义(P<0.05)。术后,两组并发症发生率比较,差异无统计学意义(P>0.05)。结论:同期输尿管软镜钬激光碎石术治疗直径<2 cm双侧上尿路结石能够提高患者结石取净率,减轻患者术后疼痛及应激反应。

Objective:To observe the clinical effect of simultaneous flexible ureteroscope holmium laser lithotripsy in the treatment of bilateral upper urinary tract stones with<2 cm in diameter.Method:A total of 96 patients with bilateral upper urinary tract stones with<2 cm in diameter admitted to Gaozhou People's Hospital from February 2021 to April 2023 were selected.They were randomly divided into observation group and extracorporeal shock wave lithotripsy(ESWL)group,48 cases in each group.ESWL group was treated with simultaneous ESWL,the observation group was treated with simultaneous flexible ureteroscope holmium laser lithotripsy.The treatment effect,pain condition 1 d and 3 d after surgery,stress index before and 3 d after surgery and complications were compared between the two groups.Result:The stone removal rate in observation group was higher than that in ESWL group,and the stone residual rate was lower than that in ESWL group,the differences were statistically significant(P<0.05).The visual analogue scale(VAS)scores of the observation group were lower than those of the ESWL group at 1 d and 3 d after surgery,and the differences were statistically significant(P<0.05).At 3 d after surgery,the levels of adrenocorticotropin(ACTH)and C-reactive protein(CRP)in observation group were lower than those in ESWL group,and the differences were statistically significant(P<0.05).After surgery,there was no significant difference in the incidence of complications between the two groups(P>0.05).Conclusion:Simultaneous flexible ureteroscope holmium laser lithotripsy in the treatment of bilateral upper urinary tract stones with<2 cm in diameter can improve the stone removal rate,alleviate postoperative pain,and reduce stress response.