改良碎石法在输尿管镜钬激光碎石术中的应用价值

目的分析改良碎石法在输尿管镜钬激光碎石术中的应用价值。方法将该院收治的240例输尿管结石患者随机分为两组,即改良组120例,对照组120例。对照组患者行常规输尿管镜钬激光碎石术治疗,改良组患者行输尿管导管旁置持续注水的输尿管镜钬激光碎石改良术治疗。分别观察并统计两组患者的结石最大直径、碎石时间、总手术时间、术中出血量；观察并统计两组患者术后并发症的发生率；同时,观察并统计两组患者的复发率。结果两组患者手术全部成功碎石,结石清除率均为100%（120/120）。改良组患者平均碎石时间、总手术时间及术中出血量依次为（9.03±3.18）min、（34.25±7.63）min、（88.46±20.34）mL；对照组依次为（12.32±3.21）min、（40.32±6.65）min、（100.23±22.17）min。两组比较,差异具有统计学意义（P〈0.05）。改良组患者术后并发症的总发生率为4.17%,对照组依为9.99%,两组比较,差异具有统计学意义（P〈0.05）。改良组患者复发率为3.33%,对照组为10%,两组比较,差异具有统计学意义（P〈0.05）。结论改良碎石法在输尿管镜钬激光碎石术的应用中,能有效缩短碎石时间和总手术时间,并减少术中出血量,降低术后并发症的发生率,且复发率低,值得临床推广与应用。

Clinical value of improved ureteroscopy holmium laser lithotripsy

Objective To analyze the value of improved ureteroscopy holmium laser lithotripsy. Methods Two hundred and forty cases of ureteral calculi patients admitted to North Hospital of Xinhua Medical Group were randomly assigned into 2 groups,namely the improvement group（ n = 120） and control group（ n = 120）. The control group received routine treatment with ureteroscopy holmium laser lithotripsy while the improvement group received improved ureteroscopy holmium laser lithotripsy in which ureteral catheter was adopted with continuous injection of water. Maximum diameter,gravel time,total operationve time,intraoperative blood loss,incidence of postoperative complications and recurrence rate in two groups were observed and recorded. Results All surgeries in two groups were successful. Stone clearance rate was 100%（120 /120）. Average gravel time,total operative time and intraoperative blood loss in improvement group were significantly different from those in control group,which were（9. 03 ± 3. 18） min vs（12. 32 ± 3. 21） min,（34. 25 ± 7. 63） min vs（40. 32 ± 6. 65）,and（88. 46 ± 20. 34） mL vs（100. 23 ± 22. 17） mL,respectively（ P 〈0. 05）. Incidence of postoperative complications and recurrence rate in improvement group were significantly different from those in control group,which were 4. 17% vs 9. 99%（ P 〈 0. 05） and 3. 33% vs 10%（ P 〈 0. 05）,respectively. Conclusions The improved ureteroscopy holmium laser lithotripsy can effectively shorten the stone breaking time and total operation time,reduce the intraoperative blood loss,the incidence of postoperative complications and recurrence rate,which is worthy of clinical popularization and application.