输尿管软镜钬激光碎石术联合负压吸引鞘治疗上尿路结石的效果观察

Therapeutic effect of ureteral flexible holmium laser lithotripsy combined with negative pressure aspiration sheath on upper urinary tract calculus

目的:探讨输尿管软镜钬激光碎石术(FURL)联合负压吸引鞘治疗上尿路结石的效果。方法:队列研究。抽取2021年5月至2023年5月河南宏力医院收治的上尿路结石患者80例,按随机数字表法分为对照组和研究组,每组40例。对照组行FURL联合非负压吸引鞘治疗,研究组行FURL联合负压吸引鞘治疗。比较两组围术期指标(术中操作时间、术中出血量、住院天数)、并发症发生率及术后结石清除率;比较两组治疗前后炎症指标[白细胞计数(WBC)、C反应蛋白(CRP)]水平。结果:研究组术中操作时间、住院天数短于对照组,术中出血量少于对照组(P<0.05)。术后3 d,研究组CRP、WBC水平低于对照组(P<0.05)。研究组并发症发生率(5.00%,2/40)低于对照组(25.00%,10/40),P<0.05。术后1、3个月,研究组结石排出率(90.00%,36/40;100%,40/40)高于对照组(72.50%,29/40;82.50%,33/40),差异有统计学意义(P<0.05)。结论:负压吸引鞘联合FURL治疗上尿路结石,可改善围术期指标,提高术后结石清除率,降低炎症反应;该方案具有较高安全性,还能降低并发症发生率。

Objective:To investigate the effects of flexible ureteroscopic holmium laser lithotripsy(FURL)combined with negative pressure aspiration sheath in the treatment of upper urinary tract calculus.Methods:A total of 80 patients with upper urinary tract calculus treated in Henan Honliv Hospital from May 2021 to May 2023 were selected for the cohort study.And they were divided into the control group and the study group by random number table method,with 40 cases in each group.The control group was treated by FURL combined with non-negative pressure aspiration sheath,and the study group was treated by FURL combined with negative pressure aspiration sheath.Perioperative indexes(operation tine during surgery,intraoperative blood loss,hospital stay),incidence of complications and postoperative stone expulsion rate of the two groups were compared.The preoperative and postoperative levels of inflammatory indexes including white blood cell count(WBC)and C-reactive protein(CRP)of the two groups were compared.Results:Compared with the control group,the operation time during surgery and hospital stay of the study group were shorter,and the amount of intraoperative blood loss of the study group was less(P<0.05).Compared with the control group,the levels of CRP and WBC in the study group were lower 3 days after surgery(P<0.05).The incidence of complications of the study group(5.00%,2/40)was lower than that of the control group(25.00%,10/40),P<0.05.The 1-and 3-month postoperative stone expulsion rate of the study group were 90.00%(36/40)and 100.00%(40/40),respectively,which were higher than those of the control group(72.50%,29/40;82.50%,33/40),and the difference was significant(P<0.05).Conclusions:Negative pressure aspiration sheath combined with FURL in the treatment of upper urinary tract calculus can improve perioperative indexes,increase postoperative stone expulsion rate and reduce inflammatory response;moreover,this protocol has a high safety,and can reduce the incidence of complications.