摘要
目的上尿路结石患者用输尿管软镜钬激光碎石术予以治疗的临床效果及安全性。方法研究对象是上尿路结石患者,病患总数是92例,采用随机数字法分为研究组与对照组,每组46例。研究组采用输尿管软镜钬激光碎石术,对照组采用输尿管硬镜钬激光碎石术。比较两组手术时间及术后康复情况、清石率(SFR)、应激指标、术后并发症发生率。结果两组手术及术后恢复的三项时间指标,对比结果提示并无明显差异(P>0.05)。术后1 d,研究组血清促肾上腺皮质激素(ACTH)(15.3±5.6)pmol/L、C反应蛋白(CRP)(14.2±5.1)mg/L与皮质醇(COR)(194.6±58.4)ng/ml显著低于对照组的(18.8±7.1)pmol/L、(19.5±6.9)mg/L、(236.9±65.7)ng/ml(P<0.05)。研究组一期SFR显著高于对照组(91.3%VS 76.1%)(P<0.05);两组术后3个月SFR比较无统计学差异(97.8%VS 93.5%)(P>0.05)。研究组术后并发症总发生率低于对照组(17.4%VS 37.0%)(P<0.05)。结论临床上针对上尿路结石患者,采取输尿管软镜钬激光碎石术的方法予以治疗无论是在有效性亦或是安全性方面均有明显的优势,作为一种安全可靠的手术方案,此种治疗措施是有临床推广价值的。
Objective This study aimed to evaluate the efficacy and safety of holmium laser lithotripsy via flexible ureteroscopy in patients with upper urinary tract stones.Methods A total of 92 patientsdiagnosed with upper urinary tract stones were enrolled and randomly assigned to two groups(n=46 each).Theexperimental group underwent flexible ureteroscopic holmium laser lithotripsy,while the control group receivedconventional ureteroscopic holmium laser lithotripsy.Surgical duration,postoperative recovery,stone clearancerate(SFR),stress-related biomarkers,and complication rates were compared between the two groups.Results No significant differences were observed in operative time,time to first postoperative flatus,and hospital stay between the two groups(P>0.05).At 24 hours post-surgery,the experimental group exhibited significantly lower levels of adrenocorticotropic hormone(ACTH:15.3±5.6 pmol/L VS 18.8±7.1 pmol/L),C-reactive protein(CRP:14.2±5.1 mg/L VS 19.5±6.9 mg/L),and cortisol(COR:194.6±58.4 ng/ml VS 236.9±65.7 ng/ml)compared to the control group(P<0.05).The immediate SFR was significantly higher in the experimental group(91.3%VS 76.1%,P<0.05),whereas nosignificant difference was noted at the 3-month follow-up(97.8%VS 93.5%,P>0.05).Additionally,theexperimental group demonstrated a lower overall complication rate(17.4%VS 37.0%,P<0.05).Conclusion Flexible ureteroscopic holmium laser lithotripsy is an effective and safe treatment for upper urinary tract stones,associated with superior stone clearance,reduced postoperative complications,and minimal physiological stress.
作者
蔡银凤
陈凤娥
郭招治
王姣莲
CAI Yin-feng;CHEN Feng-e;GUO Zhao-zhi(Department of Urology,73rd Group Military Hospital,Xiamen 361000,China)
出处
《中国现代药物应用》
2025年第10期43-46,共4页
Chinese Journal of Modern Drug Application
关键词
上尿路结石
输尿管软镜
输尿管硬镜
钬激光
清石率
应激指标
并发症
Upper urinary tract stones
Flexible ureteroscope
Ureteroscope
Holmium laser
Stone free rate
Stress index
Complications
