输尿管软镜钬激光碎石术治疗直径1~2 cm输尿管上段结石的效果

Effect of Ureteral Flexible Scope Holmium Laser Lithotripsy for the Treatment of Upper Ureteral Stones with a Diameter of 1 to 2 cm

目的:探讨输尿管软镜钬激光碎石术(FURL)治疗直径1~2 cm输尿管上段结石的效果。方法:选取2022年10月—2023年9月南海经济开发区人民医院和广州医科大学第二附属医院收治的输尿管上段结石患者90例为研究对象,按照奇偶数法随机分为观察组和对照组,各45例。观察组采用FURL,对照组采用输尿管硬镜钬激光碎石术。比较两组手术相关指标、肾功能指标、C反应蛋白(CRP)水平及并发症。结果:观察组手术时间及住院时间短于对照组,术中出血量低于对照组,差异有统计学意义(P<0.001);两组结石清除率比较,差异无统计学意义(P>0.05)。术后,两组血肌酐、血尿素氮、胱抑素C水平升高,观察组低于对照组,差异有统计学意义(P<0.05)。术后,两组CRP水平升高,观察组低于对照组,差异有统计学意义(P<0.001)。观察组并发症发生率低于对照组,差异有统计学意义(P=0.036)。结论:FURL治疗1~2 cm输尿管上段结石效果较好,可缩短手术时间、住院时间,降低术中出血量,保护肾功能,减轻炎性反应,安全性好。

Objective:To investigate the effect of ureteral flexible scope holmium laser lithotripsy(FURL)for the treatment of upper ureteral stones with a diameter of 1 to 2 cm.Methods:Ninety patients with upper ureteral stones admitted to Foshan Nanhai Economic Development Zone People's Hospital and the Second Affiliated Hospital of Guangzhou Medical University from October 2022 to September 2023 were selected for the study,and were randomly divided into an observation group and a control group,each with forty-five cases,according to the odd-even numbering method.FURL was used in the observation group,and ureteral rigid scope holmium laser lithotripsy was used in the control group.Surgery-related indexes,renal function indexes,C-reactive protein(CRP)level and complications were compared between the two groups.Results:The operation time and hospitalization time of the observation group were shorter than that of the control group,and the intraoperative bleeding was lower than that of the control group,with statistically significant differences(P<0.001);there was no statistically significant difference in the stone clearance rates of the two groups(P>0.05).Postoperatively,blood creatinine,blood urea nitrogen,cystatin C levels were elevated in both groups,and the observation group was lower than the control group,with a statistically significant difference(P<0.05).Postoperatively,CRP levels were elevated in both groups,and the observation group was lower than the control group,with a statistically significant difference(P<0.001).The complication rate of the observation group was lower than that of the control group,with a statistically significant difference(P=0.036).Conclusion:FURL is more effective in the treatment of 1-2 cm upper ureteral stones,which can shorten the operation time and hospitalization time,reduce intraoperative bleeding,protect renal function,reduce inflammatory reaction,and have good safety.