输尿管软镜与输尿管硬镜下钬激光碎石术治疗老年输尿管上段结石的效果分析

Effect of Holmium Laser Lithotripsy under Flexible Ureteroscope and Ureteroscopy for Upper Ureteral Calculi in Elderly Patients

目的:分析老年输尿管上段结石患者使用输尿管软镜与输尿管硬镜下钬激光碎石术治疗的具体效果。方法:选择2020年1月—2023年11月齐河县人民医院收治的80例老年输尿管上段结石患者作为研究对象,随机分为参照组(n=40,实施经皮肾镜钬激光碎石术),观察组(n=40,输尿管软镜与输尿管硬镜下钬激光碎石术)。比较两组患者手术相关指标、一次结石清除率及复发率、并发症发生率。结果:观察组手术时间、住院时间短于参照组,术中出血量少于参照组(P<0.001);观察组患者一次结石清除率高于参照组,术后6个月复发率低于参照组(P<0.05);观察组患者术后并发症发生率为5.00%,显著低于参照组(P<0.05)。结论:对于老年输尿病上段结石患者,输尿管软镜与输尿管硬镜下钬激光碎石术相较于经皮肾镜钬激光碎石术在手术相关指标、结石清除率、复发率和并发症发生率等方面均表现出更为优越的特点,效果显著。

Objective:To analyze the specific effects of holmium laser lithotripsy under flexible ureteroscope and ureteroscopy in elderly patients with upper ureteral calculi.Methods:Eighty elderly patients with upper ureteral calculi admitted to Qihe County People's Hospital from January 2020 to November 2023 were selected as the study objects,and were randomly divided into the reference group(n=40,percutaneous nephroscopic holmium laser lithotripsis)and the observation group(n=40,ureteroflexible and ureterohard holmium laser lithotripsis).The operative indexes,primary stone clearance rate,recurrence rate and complication rate were compared between the two groups.Results:The operation time and hospital stay in the observation group were shorter than those in the reference group,and the intraoperative blood loss was less than that in the reference group(P<0.001);the primary stone clearance rate in observation group was higher than that in reference group,and the recurrence rate at 6 months after operation was lower than that in reference group(P<0.05);the incidence of postoperative complications in observation group was 5.00%,which was significantly lower than that in reference group(P<0.05).Conclusion:Holmium laser lithotripsy under flexible ureteroscope and ureteroscopy has more superior characteristics than percutaneous nephrolithotripsy in terms of operating-related indicators,stone clearance rate,recurrence rate and complication rate for elderly patients with upper stage calculi.