输尿管软镜下钬激光碎石术治疗直径<2 cm上尿路结石的效果及对炎性因子的影响

Effect of Flexible Ureteroscopy Holmium Laser Lithotripsy in the Treatment of Upper Urinary Tract Calculi<2 cm in Diameter and its Influence on Inflammatory Factors

目的分析输尿管软镜下钬激光碎石术治疗直径<2 cm上尿路结石的效果及对炎性因子的影响。方法选取2019年1月-2022年12月我院诊治的64例上尿路结石患者为研究对象,采用随机数字表法分为对照组(n=32)和观察组(n=32),对照组采用经皮肾镜钬激光碎石术,观察组采用输尿管软镜下钬激光碎石术治疗,比较两组结石清除率、临床手术指标、疼痛情况、炎性因子水平[白细胞计数(WBC)、C反应蛋白(CRP)、白细胞介素-6(IL-6)]、并发症发生率。结果观察组结石清除率、手术时间与对照组比较,差异无统计学意义(P>0.05);观察组术中出血量少于对照组、住院时间短于对照组(P<0.05);观察组术后5、12、24 h的VAS评分均低于对照组(P<0.05);两组术后WBC、CRP、IL-6水平均高于术前,但观察组低于对照组(P<0.05);观察组并发症发生率为6.25%,低于对照组的15.63%(P<0.05)。结论直径<2 cm上尿路结石患者采用输尿管软镜下钬激光碎石术的治疗效果确切,具有结石清除率高、术中出血量少、住院时间短、疼痛度小、并发症发生率低的优势,且对炎症因子应激反应小。

Objective To analyze the effect of flexible ureteroscopy holmium laser lithotripsy in the treatment of upper urinary tract calculi<2 cm in diameter and its influence on inflammatory factors.Methods A total of 64 patients with upper urinary tract calculi treated in our hospital from January 2019 to December 2022 were selected as the research objects.They were divided into control group(n=32)and observation group(n=32)by random number table method.The control group was treated with percutaneous nephrolithotomy holmium laser lithotripsy,and the observation group was treated with flexible ureteroscopy holmium laser lithotripsy.The stone clearance rate,clinical surgical indicators,pain,inflammatory factor levels[white blood cell count(WBC),C-reactive protein(CRP),interleukin-6(IL-6)]and complication rate were compared between the two groups.Results There was no significant difference in stone clearance rate and operation time between the observation group and the control group(P>0.05).The intraoperative blood loss in the observation group was less than that in the control group,and the hospitalization time was shorter than that in the control group(P<0.05).The VAS scores of the observation group at 5,12 and 24 h after operation were lower than those of the control group(P<0.05).The levels of WBC,CRP and IL-6 in the two groups after operation were higher than those before operation,but those in the observation group were lower than those in the control group(P<0.05).The incidence of complications in the observation group was 6.25%,which was lower than 15.63%in the control group(P<0.05).Conclusion Flexible ureteroscopy holmium laser lithotripsy is effective in the treatment of patients with upper urinary tract calculi<2 cm in diameter.It has the advantages of high stone clearance rate,less intraoperative blood loss,short hospitalization time,less pain,low incidence of complications,and small stress response to inflammatory factors.