输尿管镜下钬激光碎石术与开放手术治疗输尿管结石临床对照研究

Comparative Study of Holmium Laser Lithotripsy Under Ureteroscope and Open Surgery for Ureteral Calculi

目的对比分析输尿管镜下钬激光碎石术与开放手术治疗输尿管结石的临床效果。方法回顾分析2012年3月—2016年3月北京市平谷区中医院收治的92例输尿管结石患者的临床资料,根据不同手术方式分为对照组和治疗组,各46例。对照组患者采用传统开放手术进行治疗,治疗组患者采用输尿管镜下钬激光碎石术进行治疗。比较两组患者成功取石率,观察并记录两组患者手术时间、术中出血量、住院时间及并发症发生情况。结果治疗组患者取石成功41例(89.1%),对照组患者成功取石43例(93.5%),两组患者成功取石率比较,差异无统计学意义(P>0.05)。治疗组患者手术时间、术中出血量、术后下床活动时间、住院时间均短于对照组,并发症发生率低于对照组(P<0.05)。结论与传统开放手术相比,输尿管镜下钬激光碎石术治疗输尿管结石的疗效确切,能够缩短治疗疗程,促进患者康复,具有创伤小、安全性高等特点,可作为临床治疗输尿管结石较为理想的方法。

Objective To compare the clinical effect of ureteroscopic holmium laser lithotripsy and open surgery in the treatment of ureteral calculi. Methods March 2012 to March 2016, clinical data of 92 patients with ureteral calculi in Traditional Chinese Medicine Hospital of Pinggu District were selected. According to different operation,the patients were divided into control group and treatment group,each of 46. The control group were treated by traditional open surgery treatment,the treatment group were treated by ureteroscopy holmium laser lithotripsy for treatment. The rate of lithotomy successful between the two groups were compared. Operation time, intraoperative blood loss, hospital stay, and complications in two groups were observed and recorded. Results In the treatment group,41 cases( 89. 1%) were removed successfully; in the control group,43 cases( 93. 5%) were successfully removed,there was no significant difference between groups( P > 0. 05). Operation time,intraoperative blood loss,postoperative bed activity time,length of hospital stay of treatment group were shorted than control group,complications of treatment group was lower than control group( P < 0. 05). Conclusion Compared with traditional open surgery, ureteroscopic holmium laser lithotripsy is effective for the treatment of ureteral calculi, which can shorten the course of treatment and promote the rehabilitation of patients. It has the characteristics of small trauma and high safety. It can be used as an ideal method for clinical treatment of ureteral calculi.