钬激光碎石术在老年泌尿系结石中的应用及临床疗效观察

目的:探讨输尿管下钬激光碎石(holmium laser lithotripsy,HLL)及气压弹道碎石(ureteroscopy swiss lithoclast,URSL)治疗老年泌尿系结石的临床疗效。方法:102例老年输尿管结石及膀胱结石患者,按照治疗方法分为HLL组与URSL组,比较两组临床疗效及并发症发生率。结果:HLL组患者手术时间及术后VAS评分均明显低于URSL组,差异有统计学意义(P<0.05);HLL组与URSL组患者术后并发症发生率(7.84%vs 11.46%)比较,差异无统计学意义(P>0.05);HLL组输尿管上段结石单次手术碎石有效率及总的单次碎石有效率分别为93.33%、96.08%,均明显高于URSL组,差异有统计学意义(P<0.05)。结论:HLL治疗老年泌尿系结石具有手术时间短、术后疼痛轻、碎石效果好的优点,尤其对输尿管上段结石效果更好。

Application and clinical efficacy of holmium laser lithotripsy in elderly pa-tients with urinary calculi

Objective:To investigate the clinical efficacy of holmium laser lithotripsy (HLL)and ureteroscopic pneumatic litho-tripsy (URSL)clinical efficacy in in elderly patients with urinary calculi.Methods:120 cases of elderly patients with ureteral stones and bladder stones were divided into HLL group and URSL group according to the treatment method;clinical efficacy and complication rate were compared.Results:The operative time and postoperative VAS scores in HLL group were significantly lower than those of the URSL group,the difference was statistically significant (P <0.05);there was no statistical significance in complication rate in the HLL group URSL group which was 7.84% and 1 1 .46% (P >0.05);The single gravel success rate in upper ureteral calculi and the total rate in HLL group was 93.33% 96.08% respectively,which were significantly higher than URSL group,the difference was statistically significant (P <0.05).Conclusion:The treatment of HLL in elderly patients with urinary calculi is of shorter operative time and less postoperative pain,especially for upper ureteral calculi.