输尿管软镜钬激光碎石术治疗上尿路结石效果(1)
摘 要 目的：探讨输尿管软镜钬激光碎石术治疗上尿路结石的效果。方法：收集上尿路结石患者60例，随机均分为观察组和对照组各30例。观察组采取输尿管软镜钬激光碎石术治疗，对照组采取经皮肾镜取石术治疗，比较两组患者手术情况、结石清除效果以及术后并发症情况。结果：观察组手术时间、住院时间、术后恢复时间及结石排净时间均显著低于对照组(P<0.05)。观察组结石清除率为100.00%(30/30)，显著高于对照组的76.67%(23/30，P<0.05)。观察组并发症发生率为10.00%(3/30)，显著低于对照组的33.33%(10/30，P<0.05)。结论：输尿管软镜钬激光碎石术治疗上尿路结石经自然通道，手术时间短、術后恢复快、结石清除效果好、并发症少，值得临床推荐。
关键词 上尿路结石；输尿管软镜钬激光碎石术；经皮肾镜取石术
中图分类号：R691.4 文献标志码：A 文章编号：1006-1533(2018)24-0025-03
Effect of flexible ureteroscopic holmium laser lithotripsy in the treatment of upper urinary tract calculi
CHENG Zhengxing， ZHONG Shaoyun， LIU Jiang， WANG Zhiwei， GUO Lihui
(Department of Urology Surgery of Xingang Central Hospital of Xinyu， Xinyu 338000， Jiangxi Province， China)
ABSTRACT Objective： To investigate the effect of flexible ureteroscopic holmium laser lithotripsy in the treatment of upper urinary tract calculi. Methods： Sixty patients with upper urinary tract calculi were collected and randomly divided into an observation group and a control group with 30 cases each. The observation group received flexible ureteroscopic holmium laser lithotripsy， the control group was treated by percutaneous nephrolithotomy， and the operation condition， stone clearance effect and postoperative complication of the two groups were compared. Results： The operation time， hospitalization time， postoperative recovery time and stone clearance time of the observation group were significantly lower than those of the control group(P<0.05). The stone clearance rate of the observation group was 100.00%(30/30)， which was significantly higher than that of the control group 76.67%(23/30， P<0.05). The incidence of complications of the observation group was 10.00%(3/30)， which was significantly lower than that of the control group 33.33%(10/30， P<0.05). Conclusion： Flexible ureteroscopic holmium laser lithotripsy in the treatment of upper urinary tract calculi through the natural passage has short operation time， rapid postoperative recovery， good stone removal effect， and less complications， which is worthy of clinical recommendation.
KEY WORDS upper lithangiuria； flexible ureteroscopic holmium laser lithotripsy； percutaneous nephrolithotomy
上尿路结石是临床常见的泌尿系统结石，病情复杂，取石难度较大，选择合适的取石手术是改善患者预后的关键[1]。经皮肾镜取石术、逆行肾内手术、输尿管软镜碎石术以及体外冲击波碎石术等均为治疗上尿路结石的常见术式，其中输尿管软镜结合钬激光碎石技术以其结石清除效果明确、术后易恢复、对机体损伤小等优势逐渐在临床上显示出良好的应用前景[2-3]。本文报道采用输尿管软镜结合钬激光碎石技术治疗上尿路结石患者的效果。
1 资料与方法
1.1 一般资料
收集2017年1月至12月接诊的上尿路结石患者60例，均经超声确诊，符合输尿管软镜钬激光碎石术或经皮肾镜取石术适应证，按照随机数字表法分为观察组和对照组各30例。观察组中男性18例，女性12例，年龄为30～59岁，平均(40.21±7.54)岁，病程为10 d～3年，平均(1.97±0.47)年，结石大小0.4 cm×1.0 cm～0.7cm×1.3 cm，其中肾结石19例、输尿管上段结石11例。对照组中男性17例，女性13例，年龄为31～59岁，平均(41.01±7.93)岁，病程为11 d～3年，平均(2.01±0.62)年，结石大小0.4 cm×0.9 cm～0.7 cm×1.3 cm，其中肾结石18例、输尿管上段结石12例。两组患者的性别、年龄等基线资料差异无统计学意义(P>0.05)。家属均签署知情同意书。排除急性肾衰竭者、合并其他急慢性疾病者。, 百拇医药(程正兴 钟少云 刘江 王志伟 郭丽辉)
关键词 上尿路结石；输尿管软镜钬激光碎石术；经皮肾镜取石术
中图分类号：R691.4 文献标志码：A 文章编号：1006-1533(2018)24-0025-03
Effect of flexible ureteroscopic holmium laser lithotripsy in the treatment of upper urinary tract calculi
CHENG Zhengxing， ZHONG Shaoyun， LIU Jiang， WANG Zhiwei， GUO Lihui
(Department of Urology Surgery of Xingang Central Hospital of Xinyu， Xinyu 338000， Jiangxi Province， China)
ABSTRACT Objective： To investigate the effect of flexible ureteroscopic holmium laser lithotripsy in the treatment of upper urinary tract calculi. Methods： Sixty patients with upper urinary tract calculi were collected and randomly divided into an observation group and a control group with 30 cases each. The observation group received flexible ureteroscopic holmium laser lithotripsy， the control group was treated by percutaneous nephrolithotomy， and the operation condition， stone clearance effect and postoperative complication of the two groups were compared. Results： The operation time， hospitalization time， postoperative recovery time and stone clearance time of the observation group were significantly lower than those of the control group(P<0.05). The stone clearance rate of the observation group was 100.00%(30/30)， which was significantly higher than that of the control group 76.67%(23/30， P<0.05). The incidence of complications of the observation group was 10.00%(3/30)， which was significantly lower than that of the control group 33.33%(10/30， P<0.05). Conclusion： Flexible ureteroscopic holmium laser lithotripsy in the treatment of upper urinary tract calculi through the natural passage has short operation time， rapid postoperative recovery， good stone removal effect， and less complications， which is worthy of clinical recommendation.
KEY WORDS upper lithangiuria； flexible ureteroscopic holmium laser lithotripsy； percutaneous nephrolithotomy
上尿路结石是临床常见的泌尿系统结石，病情复杂，取石难度较大，选择合适的取石手术是改善患者预后的关键[1]。经皮肾镜取石术、逆行肾内手术、输尿管软镜碎石术以及体外冲击波碎石术等均为治疗上尿路结石的常见术式，其中输尿管软镜结合钬激光碎石技术以其结石清除效果明确、术后易恢复、对机体损伤小等优势逐渐在临床上显示出良好的应用前景[2-3]。本文报道采用输尿管软镜结合钬激光碎石技术治疗上尿路结石患者的效果。
1 资料与方法
1.1 一般资料
收集2017年1月至12月接诊的上尿路结石患者60例，均经超声确诊，符合输尿管软镜钬激光碎石术或经皮肾镜取石术适应证，按照随机数字表法分为观察组和对照组各30例。观察组中男性18例，女性12例，年龄为30～59岁，平均(40.21±7.54)岁，病程为10 d～3年，平均(1.97±0.47)年，结石大小0.4 cm×1.0 cm～0.7cm×1.3 cm，其中肾结石19例、输尿管上段结石11例。对照组中男性17例，女性13例，年龄为31～59岁，平均(41.01±7.93)岁，病程为11 d～3年，平均(2.01±0.62)年，结石大小0.4 cm×0.9 cm～0.7 cm×1.3 cm，其中肾结石18例、输尿管上段结石12例。两组患者的性别、年龄等基线资料差异无统计学意义(P>0.05)。家属均签署知情同意书。排除急性肾衰竭者、合并其他急慢性疾病者。, 百拇医药(程正兴 钟少云 刘江 王志伟 郭丽辉)