摘要
目的比较输尿管软镜与硬镜下钬激光碎石术对输尿管上段复杂结石患者机体炎症反应及安全性的影响.方法选取遵义市第一人民医院(桃溪院区:原遵义市第五人民医院)2020年8月—2023年8月收治的64例输尿管上段结石患者为研究对象,按随机数字表法将其分为软镜组及硬镜组,每组32例.软镜组行输尿管软镜下钬激光碎石术,硬镜组行输尿管硬镜下钬激光碎石术.对比两组患者的手术指标、炎症反应、碎石成功率、结石排净率及安全性.结果软镜组的术中出血量为(9.64±2.55)mL,少于硬镜组的(23.78±6.90)mL,手术时间为(52.75±7.54)min,长于硬镜组的(41.96±6.48)min,术后住院时间为(3.72±0.62)d,短于硬镜组的(4.63±1.25)d,组间差异有统计学意义(P<0.05).术后1d,两组的C反应蛋白水平均较术前升高,但软镜组低于硬镜组,差异有统计学意义(P<0.05).两组的碎石成功率、结石排净率对比,组间差异无统计学意义(P>0.05).软镜组的并发症发生率为6.25%,低于硬镜组的25.00%,差异有统计学意义(P<0.05).结论相较于输尿管硬镜下钬激光碎石术,采用输尿管软镜下钬激光碎石术治疗输尿管上段复杂结石的出血量更少,引起的机体炎症反应更轻,安全性更高.
Objective To compare the effects of holmium laser lithotripsy under flexible ureteroscopy and hard ureteroscopy on the inflammatory response and safety of patients with complex upper ureteral calculi.Methods 64 patients with upper ureteral calculi admitted to Zunyi First People's Hospital(Taoxi Campus:former Fifth People's Hospital of Zunyi City)from August 2020 to August 2023 were selected as the study objects and were divided into a soft ureteroscope group and a hard ureteroscope group according to random number table method,with 32 cases in each group.Holmium laser lithotripsy under flexible ureteroscopy was performed in the soft ureteroscope group and holmium laser lithotripsy under hard ureteroscopy in the hard ureteroscope group.The surgical indexes,inflammatory response,success rate of lithotripsy,calculi removal rate and safety of the two groups were compared.Results The intraoperative blood loss in the soft ureteroscope group was(9.64±2.55)mL,less than(23.78±6.90)mL in the hard ureteroscope group,the operative time was(52.75±7.54)min,longer than(41.96±6.48)min in the hard ureteroscope group,and the postoperative hospital stay was(3.72±0.62)d,shorter than(4.63±1.25)d in the hard ureteroscope group,and the differences between the groups were statistically significant(P<0.05).On the 1st day after surgery,the C-reactive protein levels in both groups were increased,but the level of the soft ureteroscope group was lower than the that of the hard ureteroscope group,and the differences were statistically significant(P<0.05).There were no significant differences in the success rate of lithotripsis and calculi removal between the two groups(P>0.05).The incidence of complications in the soft ureteroscope group was 6.25%,lower than 25.00%in the hard ureteroscope group,and the difference was statistically significant(P<0.05).Conclusion Compared with holmium laser lithotripsy under hard ureteroscopy,holmium laser lithotripsy under flexible ureteroscopy is used in the treatment of complex upper ureteral calculi with less blood loss,less inflammatory reaction and higher safety.
作者
张永华
ZHANG Yonghua(Department of Urology,Zunyi First People's Hospital(Taoxi Campus),Zunyi Guizhou,563000,China)
出处
《反射疗法与康复医学》
2024年第6期146-148,156,共4页
Reflexology And Rehabilitation Medicine
关键词
钬激光碎石术
输尿管软镜
输尿管硬镜
术中出血量
炎症反应
安全性
Holmium laser lithotripsy
Flexible ureteroscopy
Hard ureteroscopy
Intraoperative blood loss
Inflammatory response
Security
作者简介
张永华(1982-),男,贵州遵义人,本科,主治医师,研究方向:泌尿外科常见病诊治。
