硕通镜钬激光碎石术与输尿管镜钬激光碎石术治疗上尿路结石的疗效分析

Holmium Laser Lithotripsy under Sotn-Ureterorenoscopy Versus under Ureteroscopy in the Treatment of Upper Uri⁃nary Tract Stones

目的:探讨上尿路结石患者应用硕通镜钬激光碎石术与输尿管镜钬激光碎石术治疗的疗效差异。方法:选取2020年3月—2022年2月高州市人民医院收治的上尿路结石患者68例为观察对象,根据随机数字表法分为硕通镜组与输尿管镜组,各34例。硕通镜组应用硕通镜钬激光碎石术治疗,输尿管镜组应用输尿管镜钬碎石术治疗。比较两组手术相关指标、结石清除率、术后并发症发生情况。结果:硕通镜组一次性鞘成功率高于输尿管镜组,手术时间、住院时间短于输尿管镜组,差异有统计学意义(P<0.05);术后1、30d,硕通镜组结石清除率均高于输尿管镜组,差异有统计学意义(P<0.05);硕通镜组术后并发症发生率低于输尿管镜组,差异有统计学意义(P=0.031)。结论:对上尿路结石患者在拟定手术治疗时选用硕通镜钬激光碎石术效果较好,结石清除率高,并发症少,但还应综合考虑患者机体情况等因素,选择适宜的手术方式。

Objective:To investigate the difference in the therapeutic effects of holmium laser lithotripsy under Sotn-Ureterore⁃noscopy and under conventional ureterscopy in the treatment of patients with upper urinary tract stones.Methods:68 patients with upper urinary tract stones admitted to Gaozhou City People's Hospital from March 2020 to February 2022 were selected for the study,and were divided into the Sotn-mirror group and the ureteroscopy group according to the method of random num⁃ber table,with 34 cases each.The Sotn-mirror group was treated with holmium laser lithotripsy under Sotn-mirror and the ure⁃teroscope group was treated with holmium lithotripsy under conventional ureteroscope.The two groups were compared in terms of surgery-related indexes,stone removal rate,and occurrence of postoperative complications.Results:The one-time sheath success rate of the Sotn-mirror group was higher than that of the ureteroscopy group,and the operation duration and hospital⁃ization duration were shorter than those of the ureteroscopy group,with statistically significant differences(P<0.05);the stone clearance rates of the Sotn-mirror group were higher than that of the ureteroscopy group one-day and 30-day after the opera⁃tion,with statistically significant differences(P<0.05);and the incidence of postoperative complications in the Sotn-mirror group was lower than that of the ureteroscopy group,with statistically significant differences(P=0.031).Conclusion:Holmium laser lithotripsy under Sotn-Ureterorenoscopy is more effective in patients with upper urinary tract stones,with high stone re⁃moval rate and fewer complications.However,choosing the appropriate surgical method needs a comprehensive consideration of patient's physical conditions.