摘要
目的探讨上尿路结石患者经输尿管软镜钬激光碎石术的治疗效果。方法选取2021年1月—2023年12月黔东南州人民医院泌尿外科接受治疗的上尿路结石患者90例,按治疗方法不同分为对照组与观察组,各45例。对照组患者应用经皮肾镜碎石术治疗,观察组患者应用经输尿管软镜钬激光碎石术治疗,对比2组患者的临床治疗效果。结果观察组患者的结石清除率为97.78%,高于对照组的84.44%(P<0.05)。观察组结石复发率为0,低于对照组的8.89%(P<0.05)。与对照组患者相比,观察组患者的手术治疗指标与疼痛评分情况均相对优良,手术时间为(55.53±4.27)min,短于对照组的(76.29±4.84)min;住院时间为(6.07±1.32)d,短于对照组的(9.35±1.50)d;术中出血量为(17.66±2.25)mL,少于对照组的(46.68±2.27)mL;在术后的肾功能改善情况明显,中性粒细胞明胶酶相关脂质运载蛋白(neutropil gelatinaseassociated lipocalin,NGAL)水平为(5.48±1.16)μg/L,低于对照组的(7.32±1.21)μg/L;血肌酐(serumcreatinine,Scr)水平为(67.33±7.85)μmol/L,低于对照组的(75.84±8.97)μmol/L;胱抑素C(cystatinC,CysC)水平为(525.92±81.34)μg/L,低于对照组的(633.69±70.48)μg/L(P<0.05)。观察组炎症数据指标数值相对较低,并发症发生率为4.44%,低于对照组的28.89%(P<0.05)。结论在上尿路结石患者的临床治疗中应用经输尿管软镜钬激光碎石术具有较为优良的效果,安全性与可靠性均相对较高。可有效改善患者的临床手术指标情况,可降低患者疼痛感的优势。该治疗方案还可有效改善患者的肾功能情况,且术后的复发率较低。
Objective To explore and analyze the therapeutic effect of ureteroscopic holmium laser lithotripsy in patients with upper urinary tract stones.Methods A total of 90 patients with upper urinary tract stones who received treatment in the department of urology at People′s Hospital Qiandongnan from January 2021 to December 2023 were selected.Among them,45 patients in the control group received percutaneous nephrolithotripsy,while 45 patients in the observation group received treatment with ureteral soft holmium laser lithotripsy.The clinical treatment effects of the two groups of patients were compared.Results The stone clearance rate of patients in the observation group was 97.78%,which was higher than 84.44%in the control group(P<0.05).The recurrence rate of the observation group stones was 0,lower than the control group′s 8.89%(P<0.05).Compared with the control group patients,the surgical treatment indicators and pain scores of the observation group patients were relatively good,with a surgical time of(55.53±4.27)minutes,which was shorter than the control group′s(76.29±4.84)minutes.The hospitalization time was(6.07±1.32)days,which was shorter than the control group′s(9.35±1.50)days.The intraoperative bleeding volume was(17.66±2.25)mL,which was lower than the control group′s(46.68±2.27)mL.After surgery,there was a significant improvement in renal function,with neutropil gelatinaseassociated lipocalin(NGAL)levels of(5.48±1.16)μg/L,lower than the control group′s(7.32±1.21)μg/L.The serum creatinine(Scr)level was(67.33±7.85)μmol/L,lower than the control group′s(75.84±8.97)μmol/L.The cystatin C(CysC)level was(525.92±81.34)μg/L,lower than the control group′s(633.69±70.48)μg/L(P<0.05).The inflammatory data indicators had relatively low values,with a complication rate of 4.44%,lower than the control group′s 28.89%(P<0.05).Conclusion The application of ureteroscopic holmium laser lithotripsy in the clinical treatment of upper urinary tract stones has significant results,with relatively high safety and reliability.It can effectively improve the clinical surgical indicators of patients and reduce their pain.At the same time,this treatment plan can effectively improve the renal function of patients,and the postoperative recurrence rate is low,so it can be promoted and applied in clinical practice.
作者
龙久柱
伍骏锋
张军
LONG Jiuzhu;WU Junfeng;ZHANG Jun(Department of Urology,People′s Hospital Qiandongnan,Kaili Guizhou 556000,China)
出处
《中国卫生标准管理》
2024年第11期78-81,共4页
China Health Standard Management
基金
贵州省科技计划项目(黔科合基础-ZK[2022]一般544)。
关键词
经输尿管软镜钬激光碎石术
上尿路结石
经皮肾镜碎石术
手术效果
结石手术
肾功能
ureteroscopic holmium laser lithotripsy
upper urinary tract stones
percutaneous nephrolithotripsy
surgical effect
stone surgery
renal function
