输尿管软镜钬激光碎石术与输尿管硬镜钬激光碎石术治疗输尿管结石合并肾积水的效果比较

Comparison of therapeutic effects of flexible ureteroscopic holmium laser lithotripsy and ureteroscopic holmium laser lithotripsy on ureteral calculi complicated by hydronephrosis

目的对比输尿管软镜钬激光碎石术(FUHLL)与输尿管硬镜钬激光碎石术(UHLL)治疗输尿管结石合并肾积水的临床疗效。方法抽取2020年1月至2022年12月平顶山市第一人民医院收治的输尿管结石合并肾积水患者106例,按随机数字表法将其分为对照组(52例)与观察组(54例)。对照组实施UHLL治疗,观察组实施FUHLL治疗。比较两组手术相关指标、炎症因子[C反应蛋白(CRP)、白细胞介素-6(IL-6)、降钙素原(PCT)]水平、疼痛程度[视觉模拟评分法(VAS)评分]及并发症发生情况。结果观察组术中出血量、手术操作时间、住院天数均低于对照组(P均<0.05)。术后,两组CRP、IL-6、PCT水平均高于术前,且观察组CRP、IL-6、PCT水平均低于对照组(P均<0.05)。术后12、24、48 h,观察组VAS评分均低于对照组(P均<0.05)。观察组术后并发症发生率(7.41%,4/54)低于对照组(19.23%,10/52),P<0.05。结论 FUHLL与UHLL治疗输尿管结石合并肾积水患者均有一定疗效,但FUHLL创伤更小,更利于减少术中出血量、缩短手术时间、减轻术后炎症反应及疼痛程度、降低并发症发生风险。

Objective To compare the clinical efficacy of flexible ureteroscopic holmium laser lithotripsy(FUHLL)and ureteroscopic holmium laser lithotripsy(UHLL)in the treatment of ureteral calculi complicated by hydronephrosis.Methods A total of 106 patients with ureteral calculi complicated by hydronephrosis treated in the First People’s Hospital of Pingdingshan from January 2020 to December 2022 were selected,and they were divided into control group(52 cases)and observation group(54 cases)by random number table method.The control group was treated by UHLL,while the observation group was treated by FUHLL.The surgery-related indicators,levels of inflammatory factors,including C-reactive protein(CRP),interleukin-6(IL-6)and procalcitonin(PCT),pain degree assessed by visual analogue scale(VAS)scores,and incidence of complications were compared between the two groups.Results The intraoperative bleeding volume,surgical operation time,and length of hospital stay in the observation group were all lower than those in the control group(all P<0.05).The postoperative levels of CRP,IL-6,and PCT in both groups were higher than preoperative levels,while the levels of CRP,IL-6,and PCT in the observation group were lower than those in the control group after surgery(all P<0.05).The VAS scores of the observation group at 12,24,and 48 hours after surgery were lower than those of the control group(all P<0.05).The incidence of postoperative complications in the observation group(7.41%,4/54)was lower than that in the control group(19.23%,10/52),P<0.05.Conclusions Both FUHLL and UHLL are effective in the treatment of patients with ureteral calculi complicated by hydronephrosis.However,FUHLL,compared with UHLL,has less impact on patients,and is more conducive to reducing the intraoperative bleeding volume,shortening duration of the operation,alleviating postoperative inflammatory reaction and pain degree,and reducing the risk of complications.