经皮肾镜钬激光碎石术治疗输尿管结石的研究

目的 探讨微创经皮肾镜钬激光碎石术对输尿管上段结石治疗的疗效分析.方法 将2011年3月到2013年3月在本院泌尿外科治疗的60例输尿管上段结石的患者,按随机数字分组法分为观察组(采用微创经皮肾镜钬激光碎石术)及对照组(采用开放手术治疗)各30例,通过对比两组患者手术中耗费时间、术中出血量、住院时间、术后并发症情况及随访3个月后结石的排净率和患者的满意度.结果 ①两组患者在手术时间方面比较无显著性差异(t=1.5598,P＞0.05);观察组患者的术中出血量明显少于对照组[(76.4 ±9.65)mL vs (128.3±10.32) mL],其住院时间也短于对照组[(5.86 ±1.47)d vs(7.95±1.53)d],差异均有统计学意义(P＜0.01);②观察组患者术后并发症发生率低于对照组(6.67％ vs 30％),差异有统计学意义(x2 =5.4546,P＜0.05);③随访3个月后,观察组患者与对照组的结石排净率(96.7％ vs73.3％)及满意度(100％ vs 80％)比较,差异具有统计学意义(P＜0.05).结论 输尿管上段结石采用微创经皮肾镜钬激光碎石术治疗的疗效确切,具有创伤小、结石排净率高、并发症发生率低等优势,能获得患者的满意,值得临床广泛推广.

The research of percutaneous nephroscope holmium laser lithotripsy in the treatment of ureteral calculi

Objectives To explore curative effect of minimally invasive percutaneous nephroscope holmium laser lithotripsy in the treatment of ureteric calculus.Methods 60 patients with upper ureteric calculus as the research object form March 2011 to March 2013 in our hospital were selected.They were randomly divided into the observation group (minimally invasive percutaneous nephroscope holmium laser lithotripsy) and control group (open surgery) 30 cases each group.Operation time,intraoperative blood loss,hospital stay,postoperative complications and follow-up 3 months after the stone row of net rate and patients' satisfaction were compared between two groups.Results ①There was no significant difference in operation time between two groups(t =1.5598,P ＞0.05).Intraoperative blood loss,the length of hospital stay in the observation group was less than that of control group [(76.4±9.65)mL vs (128.3± 10.32)mL],[(5.86 ± 1.47)d vs.(7.95 ± 1.53)d],the difference had statistically significance (P ＜ 0.01).②The postoperative complication rate of observation group was lower than the control group (6.67％ vs 30％),the difference had statistically significant (P ＜ 0.05).③At the follow-up of 3 months,the stone clearance rate of observation group and degree of satisfaction were significantly higher than the control group,the difference had statistically significance (P ＜ 0.05).Conclusions The minimally invasive percutaneous nephroscope holmium laser lithotripsy in the treatment of ureteric calculus has advantages of precise curative effect,small trauma,high stone clearance rate,few complications and high levels of satisfaction,it is worth clinical promotion.