摘要
目的 分析输尿管软镜联合钬激光在复杂肾结石临床治疗中的应用效果。方法 随机选取2022年2月—2023年2月沭阳中兴医院收治的80例复杂肾结石患者为研究对象,按照不同手术方法分为两组,各40例,对照组采用经皮肾镜取石术,研究组采用输尿管软镜联合钬激光碎石辅助治疗,对比两组结石清除率、术后并发症发生率、术后炎症反应、肾功能、应激刺激指标和临床症状改善情况。结果 研究组最终结石清除率为95.00%(38/40),高于对照组的77.50%(31/40),差异有统计学意义(χ^(2)=5.165,P<0.05)。研究组降钙素原、C反应蛋白、白介素-6、促肾上腺皮质激素、醛固酮、皮质醇、血肌酐、血尿素氮水平均低于对照组,首次下床活动时间、肾造瘘管留置时间和住院时间均短于对照组,差异有统计学意义(P均<0.05)。两组术后并发症总发生率比较,差异无统计学意义(P>0.05)。结论 在复杂肾结石的临床治疗中应用输尿管软镜联合钬激光碎石辅助治疗能够进一步提高结石清除率,减轻术后应激刺激和炎症反应,保护肾功能,改善预后,实用性和安全性更高。
Objective Observation of the application effect of ureteroscopy combined with holmium laser in the clini⁃cal treatment of complex kidney stones.Methods A total of 80 patients with complex renal calculi admitted to Shuy⁃ang Zhongxing Hospital from February 2022 to February 2023 were randomly selected as the research objects and di⁃vided into two groups according to different surgical methods,with 40 cases in each group.The control group was treated with percutaneous nephrolithotomy,and the study group was treated with flexible ureteroscope combined with holmium laser lithotripsy.The stone clearance rate,postoperative complication rate,postoperative inflammatory re⁃sponse,renal function,stress stimulation index and clinical symptom improvement were compared between the two groups.Results The final stone clearance rate of the study group was 95.00%(38/40),which was higher than that of the control group 77.50%(31/40),and the difference was statistically significant(χ^(2)=5.165,P<0.05).The levels of pro⁃calcitonin,C-reactive protein,interleukin-6,adrenocorticotropic hormone,aldosterone,cortisol,serum creatinine and blood urea nitrogen in the study group were lower than those in the control group,and the time of first ambulation,in⁃dwelling time of nephrostomy tube and hospitalization time were shorter than those in the control group,the differ⁃ences were statistically significant(all P<0.05).There was no significant difference in the total incidence of postopera⁃tive complications between the two groups(P>0.05).Conclusion In the clinical treatment of complex kidney stones,the combination of ureteroscopy and holmium laser lithotripsy can further improve the stone clearance rate,reduce postoperative stress stimulation and inflammatory response,protect renal function,improve prognosis,and have higher practicality and safety.
作者
秦晓春
王美才
蒋立桂
QIN Xiaochun;WANG Meicai;JIANG Ligui(Department of Urology,Shuyang Zhongxing Hospital,Suqian,Jiangsu,223600,China)
出处
《中外医疗》
2024年第30期10-14,共5页
China & Foreign Medical Treatment
关键词
输尿管软镜联合钬激光碎石
经皮肾镜取石术
复杂肾结石
肾功能
炎症反应
结石清除率
Ureteroscopy combined with holmium laser lithotripsy
Percutaneous nephrolithotomy
Complex kidney stones
Renal function
Inflammatory response
Stone clearance rate
