摘要
目的探讨输尿管硬镜结合输尿管软镜钬激光碎石术治疗复杂性输尿管上段结石患者的临床效果。方法回顾性分析2018年6月至2020年6月医院收治的102例复杂性输尿管上段结石患者的临床资料,根据手术方式的不同分为对照组和试验组,每组51例。对照组行输尿管硬镜钬激光碎石术,试验组行输尿管硬镜结合输尿管软镜钬激光碎石术,比较两组术中出血量、手术时间、住院时间、结石一次清除率,以及术前和术后3 d的炎症指标[白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)、C-反应蛋白(CRP)]水平,并统计两组术后并发症发生率和复发率。结果试验组术中出血量少于对照组,手术时间和住院时间短于对照组,结石一次清除率高于对照组,差异均有统计学意义(P<0.05)。术前,两组IL-6、TNF-α、CRP水平比较,差异无统计学意义(P>0.05);术后3 d,两组IL-6、TNF-α、CRP水平均明显升高,但试验组IL-6、TNF-α、CRP水平低于对照组,差异有统计学意义(P<0.05)。术后3个月,试验组并发症发生率低于对照组,差异有统计学意义(P<0.05);术后1年,试验组复发率低于对照组,差异有统计学意义(P<0.05)。结论输尿管硬镜结合输尿管软镜钬激光碎石术治疗复杂性输尿管上段结石患者可减少术中出血量,缩短手术时间和住院时间,且结石一次清除率较高,术后炎症指标水平较低,并可有效降低术后并发症发生率和复发率。
Objective The clinical effect of rigid ureteroscope combined with flexible ureteroscope holmium laser lithotripsy in the treatment of patients with complicated upper ureteral calculi was explored.Methods The clinical data of 102 patients with complicated upper ureteral calculi treated in the hospital from June 2018 to June 2020 was retrospectively analyzed.According to different surgical methods,they were divided into a control group and a test group,with 51 cases in each.The control group underwent rigid ureteroscope holmium laser lithotripsy,while the test group underwent rigid ureteroscope combined with flexible ureteroscope holmium laser lithotripsy.The blood loss during operation,the operation time,the hospital stay,the stone clearance rate for one time,and the levels of inflammatory response indicators[interleukin-6(IL-6),tumor necrosis factor-α(TNF-α)and C reactive protein(CRP)]before and three days after operation were compared between the two groups,and the incidence of postoperative complications and the recurrence rate of the two groups were counted.Results The blood loss during operation in the test group was less than that in the control group,the operation time and hospital stay were shorter than those in the control group,and the stone clearance rate for one time was higher than that in the control group,and the differences were statistically significant(P<0.05).Before operation,there was no statistically significant difference in the levels of IL-6,TNF-α,and CRP between the two groups(P>0.05);Three days after operation,the levels of IL-6,TNF-α,and CRP in the two groups were significantly increased,but the levels of IL-6,TNF-α,and CRP in the test group were lower than those in the control group,and the differences were statistically significant(P<0.05).Three months after operation,the incidence of complications in the test group was lower than that in the control group,and the difference was statistically significant(P<0.05);One year after operation,the recurrence rate in the test group was lo
作者
张楠根
周剑文
朱文平
辛晓雷
谢剑伟
Zhang Nangen;Zhou Jianwen;Zhu Wenping;Xin Xiaolei;Xie Jianwei(Department of Urology,Zhongshan Hospital Xiamen University,Xiamen Fujian 361004,China)
出处
《医疗装备》
2022年第5期130-133,共4页
Medical Equipment
关键词
钬激光碎石术
输尿管硬镜
输尿管软镜
复杂性输尿管上段结石
Holmium laser lithotripsy
Rigid ureteroscope
Flexible ureteroscope
Complicated upper ureteral calculi
