输尿管软镜和经皮肾镜治疗嵌顿性输尿管上段结石的效果比较

目的探讨输尿管软镜和经皮肾镜治疗嵌顿性输尿管上段结石的临床效果。方法选取52例嵌顿性输尿管上段结石患者,随机分为两组各26例。A组予以经皮肾镜治疗,B组予以输尿管软镜治疗。比较两组的结石清除情况、住院时间、术后VAS评分,以及手术前后的IL-4、IL-6、IL-10水平。结果A组术后3 d、术后3个月的结石清除率均显著高于B组(P<0.05)。A组的住院时间显著长于B组,术后VAS评分显著高于B组(P<0.05)。两组术前的IL-4、IL-6、IL-10水平无显著性差异(P>0.05);术后1 d,两组的IL-4、IL-6、IL-10水平均较术前显著升高,且A组显著高于B组(P<0.05)。结论与经皮肾镜相比,输尿管软镜治疗嵌顿性输尿管上段结石的结石清除率较低,但对患者损伤小,术后疼痛轻,恢复快。

Comparison on the Effects of Flexible Ureteroscope and Percutaneous Nephroscope in the Treatment of Incarcerated Upper Ureteral Calculi

Objective To compare the effects of flexible ureteroscope and percutaneous nephroscope in the treatment of incarcerated upper ureteral calculi.Methods 52 patients with incarcerated upper ureteral calculi were selected and randomly divided into two groups,with 26 cases in each group.Group A was treated with percutaneous nephroscope,and the group B was treated with flexible ureteroscope.The stone removal,hospitalization time,postoperative VAS score,and the IL-4,IL-6 and IL-10 levels before and after surgery were compared between two groups.Results 3 days and 3 months after surgery,the stone removal rates of group A were significantly higher than those of group B(P<0.05).The hospitalization time of group A was significantly longer than that of group B,and the postoperative VAS score was significantly higher than that of group B(P<0.05).Before surgery,no statistical difference was found between two groups in the levels of IL-4,IL-6 and IL-10(P>0.05);1 day after surgery,the levels of IL-4,IL-6 and IL-10 in both groups were significantly higher than those before surgery,and the levels of IL-4,IL-6 and IL-10 of group A were significantly higher than those of group B(P<0.05).Conclusions Compared with the percutaneous nephroscope,flexible ureteroscope has lower stone removal rate in the treatment of incarcerated upper ureteral calculi,but it has less damage to patients,less pain and quicker recovery.