输尿管软镜取石术与经皮肾镜取石术治疗单侧上尿路结石的效果比较

Comparison of the Effects of Ureteroscopic Lithotripsy and Percutaneous Nephrolithotripsy in the Treatment of Unilateral Upper Urinary Tract Stones

目的:探讨输尿管软镜钬激光碎石术(FURL)与经皮肾镜取石术(PCNL)治疗单侧上尿路结石的效果。方法:选取2021年1月~2021年12月在本院接受治疗的72例单侧上尿路结石患者为研究对象,随机分为对照组(36例)与实验组(36例),对照组开展PCNL治疗,实验组开展FURL治疗,观察两组的手术相关指标、肾功能、应激反应、免疫反应和并发症。结果:实验组肾造瘘管留置、住院时间短于对照组,手术时间长于对照组(P<0.05);实验组手术后尿素氮(BUN)、血肌酐(Scr)、β2-微球蛋白(β2-MG)水平比对照组低(P<0.05);手术后实验组血红氧合酶-1(HO-1)、内皮素-1(ET-1)水平比对照组低(P<0.05);实验组并发症发生率低于对照组(P<0.05)。结论:FURL在单侧上尿路结石治疗中相比PCNL所需时间更长,但对患者应激反应、肾功能的影响较小,安全性较高,有助于缩短患者的拔管时间,促使患者尽快出院。

Objective:To investigate the efficacy of ureteroscopic holmium laser lithotripsy(FURL)and percutaneous nephrolithotomy(PCNL)in the treatment of unilateral upper urinary tract stones.Methods:72 patients with unilateral upper urinary tract stones who received treatment in our hospital from January 2021 to December 2021 were selected as the study subjects.They were randomly divided into a control group(36 cases)and an experimental group(36 cases).The control group received PCNL treatment,while the experimental group received FUL treatment.The surgical related indicators,renal function,stress response,immune response,and complications of the two groups were observed.Results:The experimental group had a shorter retention and hospitalization time for the renal fistula tube compared to the control group,and a longer surgical time compared to the control group(P<0.05);The levels of blood urea nitrogen(BUN),creatinine(Scr),andβ2-microglobulin(β2-MG)in the experimental group were lower than those in the control group after surgery(P<0.05);After surgery,the levels of blood red oxygenase-1(HO-1)and endothelin-1(ET-1)in the experimental group were lower than those in the control group(P<0.05);The incidence of complications in the experimental group was lower than that in the control group(P<0.05).Conclusion:Compared with PCNL,FURL requires longer time in the treatment of unilateral upper urinary tract stones,but has less impact on patient stress response and renal function,and has higher safety.It helps to shorten the extubation time of patients and prompt their discharge as soon as possible.