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| Comparative Study of Combined Ureteroscopic Flexible Holmium Laser Lithotripsy and Percutaneous Nephrolithotomy in the treatment of Renal Calculi |
| CHEN Chen, WANG Chen, LI Ziliang, et al |
| The 97 Hospital of PLA, Jiangsu Xuzhou 221004, China |
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Abstract Objective: To compare the clinical efficacy of combined ureteroscopic lithotripsy with holmium laser lithotripsy and percutaneous nephrolithotomy in the treatment of renal calculi. Methods: 102 patients with renal calculi from March 2016 to August 2017 in our hospital were divided into observation group (n=51) and control group (n=51) according to different surgical methods. The control group was treated with percutaneous nephrolithotomy, and the observation group was treated by combined ureteroscope and holmium laser lithotripsy. The recovery of surgery and postoperative were compared between the two groups including (operation time, intraoperative bleeding, stone clearance rate, hospitalization time), preoperative and postoperative 72h oxidative damage index malondialdehyde (MDA), superoxide dismutase (SOD), the occurrence rate of complications and quality of life score of 3 months before and after operation. Results: Operation and postoperative recovery: There was no significant difference between the two groups of operation, 96.08% (49/51) and 94.12% (48/51)) (P > 0.05). Compared with the control group, the amount of bleeding in the observation group was less and the time of hospitalization was shorter (P < 0.05). Oxidative stress injury: There was no significant difference in serum MDA and SOD levels between the observation group and the control group before operation (P > 0.05), and 72 h after operation. The level of serum MDA in the observation group was lower than that of the control group, and the level of SOD was higher than that of the control group (P < 0.05). Complications: The incidence of postoperative complications in the observation group was 1.96% (1/51), which was lower than that in the control group (15.69%) (8/51), and the difference was statistically significant (P < 0.05). Quality of life: There was no significant difference in the quality of life between the two group before operation (P>0.05); After 3 months, the quality of life score of the observation group was higher than that of the control group(P<0.05). Conclusion: Combined ureteroscopic lithotripsy with holmium laser lithotripsy and percutaneous nephrolithotomy in the treatment of renal calculi can achieve the ideal effect of gravel, but the former than the latter to the body smaller damage, less bleeding and lighter oxidative stress response, lower complication rate, which is conducive to the early rehabilitation of patients.
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[1] 李明林.微创经皮输尿管镜钬激光碎石术和开放性手术治疗老年复杂性肾结石术后疼痛和并发症比较[J].中国老年学杂志,2015,35(7):1827~1829.
[2] 刘东波,殷德科,古孝良.经皮肾镜碎石术后并发全身炎症反应综合征的危险因素分析[J].现代泌尿外科杂志,2016,21(1):31~34.
[3] Li ZL,Deng Q,Chong T,et al.Predictors of clinical outcome after minimally invasive percutaneous nephrolithotomy for renal calculus[J].Urolithiasis,2015,43(4):355~361.
[4] 李鑫,宋波,孔广起.组合式输尿管软镜联合钬激光治疗肾及输尿管上段结石97例报告[J].中国微创外科杂志,2016,16(7):621~623.
[5] 冯瑞,李中兴,葛广成,等.微通道经皮肾镜与组合式输尿管软镜碎石术治疗肾结石比较性研究[J].国际泌尿系统杂志,2017,37(2):165~170.
[6] 乐克平,顾懿宁,刘春林,等.输尿管硬镜联合输尿管软镜钬激光碎石术治疗复杂上尿路结石疗效及术后生活质量研究[J].河北医学,2016,22(12):1985~1987.
[7] 石国忠,李风,夏宗禹,等.微通道和标准通道经皮肾镜碎石术对上尿路结石患者血流动力学和血气分析的影响[J].中国全科医学,2015,18(2):215~218.
[8] 安宇,黄建林,张峰,等.输尿管软镜与经皮肾镜钬激光碎石术对肾结石患者肾功能的影响[J].现代生物医学进展,2015,15(35):6863~6866.
[9] 金勇超,周览,王金善,等.微通道与小通道经皮肾镜碎石术治疗肾结石疗效及安全性比较[J].河北医科大学学报,2015,36(3):283.
[10] 唐浩,陈松宁,杨水华.经皮肾镜联合输尿管软镜钬激光碎石术治疗复杂性肾结石的临床疗效分析[J].安徽医药,2016,20(2):341~343.
[11] 黄建林,廖勇,安宇,等.组合式输尿管软镜钬激光碎石术治疗2cm以上肾结石36例疗效观察[J].实用医院临床杂志,2016,13(1):58~60. |
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2018, Vol. 24 
