输尿管软镜碎石术治疗单侧输尿管上段结石的临床效果分析

Clinical Effect of Ureteral Flexible Lithotripsy in the Treatment of Unilateral Upper Ureteral Calculi

目的:分析输尿管软镜碎石术治疗单侧输尿管上段结石的临床效果。方法:选取2019年1月—2022年1月广饶县人民医院泌尿外科收治的单侧输尿管上段结石患者100例作为研究对象,随机分为对照组与观察组,各50例。对照组行经皮肾镜取石术治疗,观察组行输尿管软镜碎石术治疗。比较两组术中出血量、手术时间、住院时间、结石清除率、肾功能指标、并发症发生情况。结果:两组手术时间比较,差异无统计学意义(P>0.05);观察组术中出血量少于对照组,术后住院时间短于对照组,差异有统计学意义(P<0.05)。观察组结石清除率(94.00%)高于对照组(86.00%),差异有统计意义(P=0.001,χ^(2)=7.112)。治疗前,两组尿素氮(BUN)、血肌酐(SCr)、尿酸(UA)、内生肌酐清除率(Ccr)、24 h尿蛋白水平比较,差异无统计学意义(P>0.05);治疗后,两组BUN、SCr、UA、24 h尿蛋白水平均低于治疗前,且观察组低于对照组,两组Ccr水平高于治疗前,且观察组高于对照组,差异有统计学意义(P<0.05)。观察组并发症总发生率低于对照组,差异有统计学意义(P=0.013)。结论:输尿管软镜碎石术治疗单侧输尿管上段结石的临床效果显著,能够减少术中出血量,改善患者肾功能,降低术后并发症发生率,缩短其住院时间。

Objective:To analyze the clinical effect of flexible ureteral lithotripsy in the treatment of unilateral upper ureteral calculi.Methods:A total of one hundred patients with unilateral upper ureteral calculi admitted to the Department of Urology of Guangrao County People's Hospital from January 2019 to January 2022 were selected as the study objects and randomly divided into control group and observation group,with fifty cases in each group.The control group was treated with percutaneous nephrolithotomy,and the observation group was treated with flexible ureteral lithotripsy.Intraoperative blood loss,operation time,hospital stay,stone clearance rate,renal function index and complications were compared between the two groups.Results:There was no significant difference in operation time between the two groups(P>0.05);the intraoperative blood loss in the observation group was less than that in the control group,and the postoperative hospitalization time was shorter than that in the control group,the difference was statistically significant(P<0.05);the stone clearance rate of observation group(94.00%) was higher than that of control group(86.00%),and the difference was statistically significant(P=0.001,χ~2=7.112);before treatment,there were no significant differences in urea nitrogen(BUN),blood creatinine(SCr),uric acid(UA),endogenous creatinine clearance(Ccr) and24 h urinary protein levels between the two groups(P>0.05);after treatment,BUN,SCr,UA and 24 h urinary protein levels in2 groups were lower than before treatment,and observation group was lower than control group,Ccr level in two groups was higher than before treatment,and observation group was higher than control group,the difference was statistically significant(P<0.05);the total incidence of complications in the observation group was lower than that in the control group,the difference was statistically significant(P=0.013).Conclusion:Flexible ureteral lithotripsy has significant clinical effects in the treatment of unilateral upper ureteral calculi,which can reduce intraoperative blood loss,improve renal function,reduce the incidence of postoperative complications,and shorten the length of hospital stay.