摘要
目的比较输尿管软镜钬激光碎石术治疗不同大小肾结石的临床疗效。方法回顾性分析2016年6月至2018年3月在我科接受输尿管软镜钬激光碎石术治疗肾结石的121例患者的临床资料,按结石大小分为A组(结石长径≤20 mm)94例、B组(20 mm<结石长径≤30 mm)27例,比较其手术时间、术后住院天数、术后体外冲击波碎石(ESWL)率、并发症及清石率等,评价其临床疗效。结果121例患者均顺利完成手术,A、B两组在手术时间[(46±13)min vs(68±20)min]、术后住院天数[(4.4±1.3)d vs(5.6±1.7)d]及术后选择ESWL率[10.64%(10/94)vs 25.93%(7/27)]等方面差异有统计学意义(P<0.05);在术后总并发症(包括术后腰痛、发热、尿脓毒血症等)发生率[12.77%(12/94)vs 18.52%(5/27)]、总清石率[89.36%(84/94)vs 81.48%(22/27)]等方面差异无统计学意义(P>0.05)。结论应用输尿管软镜钬激光碎石术治疗长径20~30 mm的上尿路结石,在积极防治并发症、术后辅以ESWL等综合治疗下,能取得与结石长径≤20 mm相似的碎石效果。
Objective To evaluate the clinical efficacy of flexible ureteroscopic holmium laser lithotripsy for the treatment of renal stones with different size.Methods The data of 121 patients who underwent flexible ureteroscopic holmium laser lithotripsy for the treatment of renal stones between June 2016 and March 2018 were retrospectively analyzed,according to the size of the stones were divided into group A(94 cases,stone diameter≤20 mm)and group B(27 cases,20 mm<stone diameter≤30 mm),The difference about the operation time,the hospitalization time,the complications,the extracorporeal shock wave lithotripsy(ESWL)using rate and the stone clearance rate between the two groups were dompared.Results The operation time,the hospitalization time in group A were(46±13)min and(4.4±1.3)d,and shorter than that of group B[(68±20)min and(5.6±1.7)d,all P<0.05].Similarly,the ESWL using rate of the former was 10.64%(10/94),lower than the latter[25.93%(7/27)(P<0.05)].The total occurrence rate of complications(lumbago,fever,urosepsis)was 12.77%(12/94)vs 18.52%(5/27),stone clearance rate was 89.36%(84/94)and 81.48%(22/27)in the two groups respectively,there were no statistic differences between them(P>0.05).Conclusions The flexible ureteroscopic holmium laser lithotripsy could be one of the effective methods in the treatment of renal stones burdens that measure 20 to 30 mm,it has managed to get clinical results similar to renal stones less than 20 mm,by preventing and curing complications and choosing ESWL in some situations actively.
作者
李海博
周伟民
秦振乾
袁雪峰
谢益敏
Li Haibo;Zhou Weimin;Qin Zhenqian;Yuan Xuefeng;Xie Yimin(Department of Urology,Affiliated Yixing Hospital of Jiangsu University,Jiangsu 214200,China)
出处
《中华腔镜泌尿外科杂志（电子版）》
2020年第1期44-47,共4页
Chinese Journal of Endourology(Electronic Edition)
基金
无锡市卫生计生委科研项目,面上基金项目(MS201812)
青年基金项目(Q201807)。
关键词
输尿管软镜
钬激光
肾结石
回顾性病例对照研究
Flexible ureteroscopc lithotripsy
Holmium laser
Renal stone
Retrospective case-control study
