双J管预扩张对输尿管软镜钬激光碎石治疗肾结石疗效的影响

Effect of double J-tube pre-dilatation on the efficacy of holmium laser lithotripsy with flexible ureteroscope in the treatment of renal calculi

目的探讨双J管预扩张对输尿管软镜钬激光碎石治疗肾结石疗效的影响。方法 144例肾结石患者,根据处理方法不同分为对照组(85例)和观察组(59例)。对照组患者采用输尿管软镜钬激光碎石,观察组患者采用双J管预扩张输尿管软镜钬激光碎石。比较两组患者软镜通道鞘放置一次成功率;住院时间、术后发热时间;手术前后患者生活质量评分、机体炎症指标水平、疼痛程度;手术并发症发生情况。结果观察组患者软镜通道鞘放置一次成功率为100.00%,高于对照组的80.00%,差异具有统计学意义(P<0.05)。手术前,两组生活质量评分、C反应蛋白(CRP)水平、疼痛评分比较差异无统计学意义(P>0.05);手术后,观察组患者生活质量评分(90.24±6.11)分高于对照组的(82.24±5.12)分,CRP水平(2.22±1.16)mg/L、疼痛评分(1.11±0.21)分低于对照组的(4.22±1.59)mg/L、(2.46±0.77)分,差异具有统计学意义(P<0.05)。观察组患者住院时间、术后发热时间分别为(4.02±0.11)、(2.11±0.21)d,均短于对照组的(6.14±0.21)、(3.62±1.59)d,差异具有统计学意义(P<0.05)。观察组患者手术并发症发生率为1.69%,低于对照组的15.29%,差异具有统计学意义(P<0.05)。结论肾结石患者行双J管预扩张输尿管软镜钬激光碎石软镜通道鞘放置一次成功率高,可更好地改善生活质量、机体炎症指标水平、疼痛程度,加速康复。

Objective To discuss the effect of double J-tube pre-dilatation on the efficacy of holmium laser lithotripsy with flexible ureteroscope in the treatment of renal calculi.Methods A total of 144 renal calculi patients were divided by different process methods into control group(85 cases)and observation group(59 cases).The control group was treated with holmium laser lithotripsy with flexible ureteroscope,and the observation group was treated with double J-tube pre-dilatation of holmium laser lithotripsy with flexible ureteroscope.Comparison were made on one-time success rate of soft mirror channel sheath placement,hospitalization time,fever time after operation,quality of life score,body inflammatory indexes and pain degree before and after operation,and occurrence of surgery complications between the two groups.Results The observation group had higher onetime success rate of soft mirror channel sheath placement as 100.00%than 80.00%in the control group,and the difference was statistically significant(P<0.05).Before operation,both groups had no statistically significant difference in quality of life score,C-reactive protein(CRP)level and pain score(P>0.05).After operation,the observation group had higher quality of life score as(90.24±6.11)points than(82.24±5.12)points in the control group,and lower CRP as(2.22±1.16)mg/L and pain score as(1.11±0.21)points than(4.22±1.59)mg/L and(2.46±0.77)points in the control group.Their difference was statistically significant(P<0.05).The observation group had shorter hospitalization time and fever time after operation as(4.02±0.11)and(2.11±0.21)d than(6.14±0.21)and(3.62±1.59)d in the control group.Their difference was statistically significant(P<0.05).The observation group had lower incidence of surgical complications as 1.69%than 15.29%in the control group,and the difference was statistically significant(P<0.05).Conclusion Double J-tube pre-dilatation of ureteroscope holmium laser lithotripsy with flexible ureteroscope has a high success rate,and it can better improve the quality of life,body inflammation index level,pain level and accelerate rehabilitation.