输尿管软镜钬激光碎石与部分无管化经皮肾镜钬激光碎石术对上尿路结石促进患者术后康复的效果对比

doi:10.3969/j.issn.1006-6233.2020.12.017

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摘要 目的: 比较输尿管软镜钬激光碎石与部分无管化经皮肾镜钬激光碎石术对上尿路结石患者效果及患者术后康复情况。方法: 回顾性分析我院2016年8月至2019年5月收治的上尿路结石患者131人作为研究对象,根据患者采用的手术方式将其分为A组69例(行输尿管软镜钬激光碎石)与B组62例(行无管化经皮肾镜钬激光碎石);观察两组患者手术时间、术后血红蛋白(Hemoglobin,Hb)、术后白细胞(leukocyte,white blood cell,WBC)、平均住院时间情况;术后2d、15d、1个月时碎石清除率情况;并对患者术后并发症情况进行记录比较。结果: A组手术时间显著长于B组,术后住院时间显著短于B组,差异具有统计学意义(P<0.05);术后白细胞、血红蛋白水平比较,差异无统计学意义(P>0.05)。术后两组患者碎石率组间比较结果显示:差异具有统计学意义(P<0.05)。重复测量时点比较结果显示:差异具有统计学意义(P<0.05)。术后2d、术后15d碎石清除率与术后1个月对比,差异具有统计学意义(P<0.05)。两组患者术后均未发生感染、感染性休克及脓毒血症等较为严重并发症;两组患者发热并发症比较,差异具有统计学意义(P<0.05);总发生率比较,B组显著高于A组,差异具有统计学意义(P<0.05)。结论: 输尿管软镜钬激光碎石与部分无管化经皮肾镜钬激光碎石术对上尿路结石患者均具有较好的效果,但前者患者术后并发症发生率更低。

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	王鹏
	冷国雄
	权良明

关键词 ：激光碎石术, 上尿路结石, 输尿管镜钬激光碎石术, 无管经皮肾镜钬激光碎石术

Abstract：Objective: To compare the effect of ureteroscopic holmium laser lithotripsy and partial tubular percutaneous nephrolithotripsy on patients with upper urinary calculi and their postoperative rehabilitation. Methods: 131 patients with upper urinary tract calculi admitted to our hospital from August 2016 to may 2019 were analyzed retrospectively. According to the operation methods, they were divided into group A (69 cases) with ureteroscopic holmium laser lithotripsy (holmium laser lithotripsy) and group B (62 cases) with tubeless holmium laser lithotripsy (holmium laser lithotripsy); the operation time and postoperative hemoglobin (hemoglobin) of the two groups were observed, HB, white blood cell (WBC), average hospitalization time, lithotripsy clearance rate at 2 days, 15 days and 1 month after operation, and postoperative complications were recorded and compared. Results: The operation time of group A was significantly longer than that of the group B, and the postoperative hospitalization time was significantly shorter than that of group B, and the difference was statistically significant (P<0.05). Levels of white blood cells and hemoglobin were compared, and the difference was not statistically significant (P<0.05). Lithotripsy clearance rates at 2 days, 15 days and 1 month after operation were compared, and the difference was statistically significant (P<0.05). There were no serious complications such as infection, septic shock and sepsis in both groups after operation. The incidence of fever in group B was significantly higher than that in group A, and the difference was statistically significant (P<0.05). Conclusion: Ureteroscopic holmium laser lithotripsy and partial tubeless percutaneous nephrolithotripsy have better effect on patients with upper urinary calculi, but the incidence of postoperative complications in the former patients is lower.

Key words： Keywords laser lithotripsy Upper urinary calculi Ureteroscopic holmium laser lithotripsy Tubeless percutaneous nephrolithotomy holmium laser lithotripsy

基金资助:安徽省自然科学基金项目,(编号:1808062MH106)

通讯作者: 冷国雄

引用本文:

王鹏, 冷国雄, 权良明. 输尿管软镜钬激光碎石与部分无管化经皮肾镜钬激光碎石术对上尿路结石促进患者术后康复的效果对比[J]. 河北医学, 2020, 26(12): 2008-2011.
WANG Peng, LENG Guoxiong, QUAN Liangming. Comparison of the Effects of Ureteroscopic Holmium Laser Lithotripsy and Partial Tubeless Percutaneous Nephrolithotripsy on Postoperative Recovery of Upper Urinary Calculi. HeBei Med, 2020, 26(12): 2008-2011.

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http://www.hbyxzzs.cn/CN/10.3969/j.issn.1006-6233.2020.12.017 或 http://www.hbyxzzs.cn/CN/Y2020/V26/I12/2008

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