输尿管软镜钬激光碎石与体外震波碎石术的疗效对比分析

Comparative analysis of the efficacy of ureteral flexible holmium laser lithotripsy and extracorporeal shock wave lithotripsy

目的探讨输尿管软镜钬激光碎石与体外震波碎石的临床疗效。方法选取2020年2月至2021年5月广州医科大学附属第四医院接受治疗的68例肾结石患者作为研究对象,按照随机数字表法分为对照组与观察组,每组34例。对照组采用体外震波碎石术,观察组实施输尿管软镜钬激光碎石术。比较两组手术相关指标、肾功能指标、临床疗效、并发症发生情况。结果观察组疼痛消失时间、小便带血消失时间均短于对照组,一次性碎石成功率、3个月内结石排净率均高于对照组,差异有统计学意义(P<0.05)。术后,两组血肌酐、尿素氮水平均低于术前,内生肌酐清除率均高于术前,且观察组术后血肌酐、尿素氮水平均低于对照组,内生肌酐清除率高于对照组,差异有统计学意义(P<0.05)。观察组治疗总有效率为97.06%,高于对照组的79.41%,差异有统计学意义(P<0.05)。观察组并发症发生率为5.88%,低于对照组的26.47%,差异有统计学意义(P<0.05)。结论输尿管软镜钬激光碎石术治疗肾结石患者的有效性高于体外震波碎石术,在改善临床症状、肾功能方面的效果更优,能提高一次性碎石成功率、3个月内结石排净率,降低并发症发生率。

Objective To investigate the clinical efficacy of ureteral flexible holmium laser lithotripsy and extracorporeal shock wave lithotripsy.Methods A total of 68 patients with kidney stones who received treatment in the Fourth Affiliated Hospital of Guangzhou Medical University from February 2020 to May 2021 were selected as the study subjects,and they were divided into the control group and the observation group according to random number table method,with 34 cases in each group.The control group underwent extracorporeal shock wave lithotripsy,and the observation group underwent ureteroscopic holmium laser lithotripsy.The operation related indexes,renal function indexes,clinical efficacy and complications were compared between the two groups.Results The disappearance time of pain and blood in urine in the observation group was shorter than that in the control group,and the success rate of one-time lithotriptic and stone removal rate within 3 months were higher than those in the control group,the differences were statistically significant(P<0.05).After surgery,serum creatinine and urea nitrogen of the two groups were lower than before sur-gery,and endogenous creatinine clearance of the two groups were higher than before surgery,and postoperative serum creatinine and urea nitrogen in the observation group were lower than those in the control group,and endogenous creatinine clearance was higher than that in the control group,and the differences were statistically significant(P<0.05).The total effective rate in the observation group was 97.06%,which was higher than 79.41%in the control group,and the difference was statistically significant(P<0.05).The incidence of complications in the observation group was 5.88%,which was lower than 26.47%in the control group,and the difference was statistically significant(P<0.05).Conclusion Ureteral flexible holmium laser lithotripsy is more effective than extracorporeal shock wave lithotripsy in the treatment of patients with kidney stones,and has better effects in improving clinical symptoms and renal function,and can better improve the success rate of one-time lithotripsy,stone removal rate within 3 months,and reduce the incidence of complications.