摘要
目的比较不同手术方式(输尿管软镜钬激光碎石取石术与体外震波碎石术)治疗肾输尿管结石的有效性和安全性。方法选取152例肾输尿管结石患者,按照治疗方法不同分为体外震波组(80例)和软镜钬激光组(72例)。体外震波组予以体外震波碎石术治疗,软镜钬激光组予以输尿管软镜钬激光碎石取石术治疗。比较两组肾功能水平,术后临床症状消失时间,临床疗效,术后并发症发生率。结果两组术前血肌酐(Scr)、尿素氮(BUN)水平比较无统计学差异(P>0.05);术后1 d,两组的Scr、BUN水平高于术前,软镜钬激光组Scr(70.96±6.87)μmol/L、BUN(5.99±0.50)mmol/L低于体外震波组的(76.48±7.65)μmol/L、(7.18±0.70)mmol/L(P<0.05)。软镜钬激光组术后疼痛消失时间(2.51±0.96)d、术后小便带血消失时间(2.56±0.93)d均短于体外震波组的(4.90±2.32)、(3.66±1.24)d(P<0.05)。软镜钬激光组总有效率97.22%高于体外震波组的83.75%(P<0.05)。软镜钬激光组术后并发症发生率9.72%低于体外震波组的28.75%(P<0.05)。结论输尿管软镜钬激光碎石取石术治疗肾输尿管结石的效果优于体外震波碎石术,可有效减少并发症,促进术后快速恢复。但本文研究病例样本纳入较少,致使研究具有一定局限性,需进一步增加样本量进行多中心研究证实。
Objective To compare the effectiveness and safety of different surgical methods(flexible ureteroscopic holmium laser lithotripsy and extracorporeal shock wave lithotripsy)for renal or ureteral calculi.Methods 152 patients with renal or ureteral calculi were selected and divided into extracorporeal shock wave group(80 cases)and flexible ureteroscopic holmium laser group(72 cases)according to different treatment methods.The extracorporeal shock wave group was treated with extracorporeal shock wave lithotripsy,and the flexible ureteroscopic holmium laser group was treated with flexible ureteroscopic holmium laser lithotripsy.The renal function,disappearance time of clinical symptoms,clinical efficacy,and the incidence of postoperative complications were compared between the two groups.Results Before surgery,there were no significant differences in serum creatinine(Scr)and blood urea nitrogen(BUN)levels between the two groups(P>0.05).1 d after surgery,the levels of Scr and BUN in both groups were higher than those before surgery;the flexible ureteroscopic holmium laser group had an Scr of(70.96±6.87)μmol/L and a BUN of(5.99±0.50)mmol/L,which were lower than(76.48±7.65)μmol/L and(7.18±0.70)mmol/L in the extracorporeal shock wave group(P<0.05).In the flexible ureteroscopic holmium laser group,the disappearance time of postoperative pain was(2.51±0.96)d and the disappearance time of postoperative bloody urine was(2.56±0.93)d,which were shorter than(4.90±2.32)and(3.66±1.24)d in the extracorporeal shock wave group(P<0.05).The total effective rate of the flexible ureteroscopic holmium laser group was 97.22%,which was higher than 83.75%of the extracorporeal shock wave group(P<0.05).The incidence of postoperative complications in the flexible ureteroscopic holmium laser group was 9.72%,which was lower than 28.75%in the extracorporeal shock wave group(P<0.05).Conclusion The effect of flexible ureteroscopic holmium laser lithotripsy for the treatment of renal or ureteral calculi is better than that of extracorporeal shock wave lithotripsy,which can effectively reduce complications and promote rapid postoperative recovery.However,the study has certain limitations due to the inclusion of a small sample of cases in this paper,and it needs to be confirmed by multi-center study.
作者
张辉
韩星
岳倩
ZHANG Hui;HAN Xing;YUE Qian(Urology Department,Gaomi People's Hospital,Gaomi 261500,China)
出处
《中国实用医药》
2025年第2期41-44,共4页
China Practical Medicine
关键词
输尿管软镜钬激光碎石取石术
肾结石
输尿管结石
肾功能
体外震波碎石术
Flexible ureteroscopic holmium laser lithotripsy
Renal calculi
Ureteral calculi
Renal function
Extracorporeal shock wave lithotripsy
