输尿管软镜钬激光碎石术对上尿路结石患者结石清除效果及应激指标的影响

Effect of Flexible Ureteroscopic Holmium Laser Lithotripsy on Stone Clearance and Stress Indexes in Patients with Upper Urinary Tract Calculi

目的研究输尿管软镜钬激光碎石术(FURS)对上尿路结石患者结石清除效果及应激指标的影响。方法以2021年5月-2023年5月新干县中医院收治的80例上尿路结石患者为研究对象,经随机数字表法分为对照组(40例)与观察组(40例),对照组行经皮肾镜碎石取石术(PCNL)治疗,观察组则采用FURS治疗,比较两组结石清除效果、围术期指标(手术时间、术中出血量、术后下床时间)、术后疼痛程度[视觉模拟评分(VAS)]、应激指标[白细胞计数(WBC)、C反应蛋白(CRP)]及手术并发症。结果观察组术后15 d、1个月结石清除率均高于对照组(P<0.05)。观察组手术时间、术后下床时间均短于对照组,且术中出血量少于对照组(P<0.05)。观察组术后12 h VAS评分小于对照组(P<0.05)。两组术后12 h WBC、CRP水平均高于术前,但观察组WBC、CRP水平低于对照组(P<0.05)。观察组手术并发症发生率低于对照组(P<0.05)。结论FURS治疗上尿路结石效果确切,结石清除率高、手术时间短、术中出血少、术后疼痛轻、应激小,可有效缩短患者术后恢复时间,降低手术并发症风险。

Objective To study the effect of flexible ureteroscopic holmium laser lithotripsy(FURS)on stone clearance and stress indicators in patients with upper urinary tract stones.Methods From May 2021 to May 2023,80 patients with upper urinary tract calculi admitted to Xingan County Hospital of Traditional Chinese Medicine were selected as the research objects.They were divided into control group(40 patients)and observation group(40 patients)by random number table method.The control group was treated with percutaneous nephrolithotomy(PCNL),while the observation group was treated with FURS.The stone removal effect,perioperative indicators(operation time,intraoperative blood loss,postoperative ambulation time),postoperative pain degree[Visual Analogue Scale(VAS)],stress indicators[white blood cell count(WBC),C-reactive protein(CRP)]and surgical complications were compared between the two groups.Results The stone clearance rate of the observation group was higher than that of the control group at 15 days and 1 month after operation(P<0.05).The operation time and postoperative ambulation time in the observation group were shorter than those in the control group,and the intraoperative blood loss was less than that in the control group(P<0.05).The VAS score at 12 h after operation in the observation group was lower than that in the control group(P<0.05).The levels of WBC and CRP at 12 h after operation in the two groups were higher than those before operation,but the levels of WBC and CRP in the observation group were lower than those in the control group(P<0.05).The incidence of surgical complications in the observation group was lower than that in the control group(P<0.05).Conclusion FURS is effective in the treatment of upper urinary tract calculi.It has the advantages of high stone clearance rate,short operation time,less intraoperative bleeding,less postoperative pain and less stress.Meanwhile,it can effectively shorten the postoperative recovery time and reduce the risk of surgical complications.