输尿管软镜碎石术治疗单侧输尿管上段结石的效果分析

Analysis of Effect of Flexible Ureteroscopic Lithotripsy in Treatment of Unilateral Upper Ureteral Calculi

目的:分析单侧输尿管上段结石患者实施输尿管软镜碎石术(FURL)的治疗效果。方法:选取2021年10月—2022年10月苏州永鼎医院收治的50例单侧输尿管上段结石患者作为研究对象,采用随机数字表法分为对照组和观察组,各25例。对照组采用经皮肾镜取石术治疗,观察组采用FURL治疗。比较两组手术指标、疼痛情况、肾功能指标、并发症发生情况。结果:观察组术中出血量低于对照组,住院时间短于对照组,差异具有统计学意义(P<0.001)。术后1、3、7 d,观察组视觉模拟评分法评分均低于对照组,差异具有统计学意义(P<0.001)。术后,两组血肌酐、血尿素氮、尿酸水平低于术前,且观察组低于对照组,两组内生肌酐清除率高于术前,且观察组高于对照组,差异有统计学意义(P<0.05)。观察组并发症发生率低于对照组,差异有统计学意义(P=0.047)。结论:FURL治疗单侧输尿管上段结石的效果显著,可减少术中出血量,缩短住院时间,减轻疼痛程度,改善肾脏功能,降低术后并发症发生率。

Objective:To analyze the treatment effect of flexible ureteroscopic lithotripsy(FURL)on patients with unilateral upper ureteral calculi.Methods:A total of 50 patients with unilateral upper ureteral calculi admitted to Suzhou Yongding Hospital from October 2021 to October 2022 were selected as the study subjects.They were divided into control group and observation group according to random number table method,with 25 cases in each group.The control group was treated with percutaneous nephrolithotomy,and the observation group was treated with FURL.The operation indexes,pain,renal function indexes,and complications were compared between the two groups.Results:The intraoperative blood loss in the observation group was lower than that in the control group,and the length of hospital stay in the observation group was shorter than that in the control group,and the difference was statistically significant(P<0.001).On Days 1,3,and 7 after surgery,the scores of the visual analogue scale in the observation group were lower than those in the control group,and the difference was statistically significant(P<0.001).After operation,the levels of serum creatinine,blood urea nitrogen and uric acid in the two groups were lower than those before operation,and those in the observation group were lower than those in the control group,while the endogenous creatinine clearance rate in the two groups was higher than that before operation,and the rate in the observation group was higher than that in the control group,and the difference was statistically significant(P<0.05).The incidence of complications in the observation group was lower than that in the control group,and the difference was statistically significant(P=0.047).Conclusion:The effect of FURL in the treatment of unilateral upper ureteral calculi is significant.It can reduce intraoperative blood loss,shorten the length of hospital stay,relieve pain,improve renal function,and reduce the incidence of postoperative complications.