体外冲击波碎石与输尿管硬镜钬激光碎石对上尿路结石患者的结石清除效果比较

Comparison of Extracorporeal Shock Wave Lithotripsy and Ureteral Scleroscope Holmium Laser Lithotripsy for Stone Removal in Patients with Upper Urinary Tract Stones

目的:探讨体外冲击波碎石与输尿管硬镜钬激光碎石对上尿路结石患者的结石清除效果。方法:选取2018年1月—2022年4月徐州医科大学附属沭阳医院收治的82例上尿路结石患者作为研究对象,通过随机数表法分为常规组41例和研究组41例。常规组使用体外冲击波碎石,研究组使用输尿管硬镜钬激光碎石治疗。对比两组患者手术相关指标、炎性因子水平,降钙素原(PCT)、C反应蛋白(CRP)、术后4周结石清除率及术后并发症发生情况。结果:研究组手术时间短于常规组,差异有统计学意义(t=3.466,P<0.05)。两组患者术后PCT、CRP水平与术前相比均升高,研究组术后PCT、CRP水平均低于常规组,差异有统计学意义(t=3.370、4.484,P<0.05)。研究组术后4周结石清除率高于常规组,差异有统计学意义(χ^(2)=4.479,P<0.05)。结论:输尿管硬镜钬激光碎石治疗上尿路结石患者可缩短手术时间,有利于降低患者炎性因子水平,提高患者结石清除率,且安全。

Objective:To compare the effectiveness of extracorporeal shockwave lithotripsy with ureteral scleroscope holmium laser lithotripsy for stone removal in patients with upper urinary tract stones.Methods:82 cases of patients with upper urinary tract stones admitted to the hospital from January 2018 to April 2022 were selected and divided into conventional group and study group by randomized numerical table method,with 41 cases in each group.The conventional group was treated with extracorporeal shock wave lithotripsy,and the study group was treated with holmium laser lithotripsy with ureteral rigid lens.Surgery-related indexes,inflammatory factor levels,procalcitoninogen(PCT),C-reactive protein(CRP),stone clearance rate at 4 weeks postoperatively,and the occurrence of postoperative complications were compared between the two groups.Results:The operation time of the conventional group was shorter than that of the study group,and the difference was statistically significant(t=3.466,P<0.05).The postoperative PCT and CRP levels were elevated in both groups compared with the preoperative period,and the postoperative PCT and CRP levels in the study group were lower than those in the conventional group,and the difference was statistically significant(t=3.370,4.484,P<0.05).The stone clearance rate at 4 weeks postoperatively was higher in the study group than in the conventional group,and the difference was statistically significant(χ^(2)=4.479,P<0.05).Conclusion:Ureteral scleroscopic holmium laser lithotripsy for the treatment of patients with upper urinary tract stones reduces the duration of the procedure,facilitates the reduction of the level of inflammatory factors in patients,and improves the rate of stone clearance in patients in a safe manner.