Comparison of the Effects of Holmium Laser Lithotripsy Under Flexible Ureteroscopy and Hard Ureteroscopy on the Inflammatory Response and Safety of Patients with Complex Upper Ureteral Calculi
Objective To compare the effects of holmium laser lithotripsy under flexible ureteroscopy and hard ureteroscopy on the inflammatory response and safety of patients with complex upper ureteral calculi.Methods 64 patients with upper ureteral calculi admitted to Zunyi First People's Hospital(Taoxi Campus:former Fifth People's Hospital of Zunyi City)from August 2020 to August 2023 were selected as the study objects and were divided into a soft ureteroscope group and a hard ureteroscope group according to random number table method,with 32 cases in each group.Holmium laser lithotripsy under flexible ureteroscopy was performed in the soft ureteroscope group and holmium laser lithotripsy under hard ureteroscopy in the hard ureteroscope group.The surgical indexes,inflammatory response,success rate of lithotripsy,calculi removal rate and safety of the two groups were compared.Results The intraoperative blood loss in the soft ureteroscope group was(9.64±2.55)mL,less than(23.78±6.90)mL in the hard ureteroscope group,the operative time was(52.75±7.54)min,longer than(41.96±6.48)min in the hard ureteroscope group,and the postoperative hospital stay was(3.72±0.62)d,shorter than(4.63±1.25)d in the hard ureteroscope group,and the differences between the groups were statistically significant(P＜0.05).On the 1st day after surgery,the C-reactive protein levels in both groups were increased,but the level of the soft ureteroscope group was lower than the that of the hard ureteroscope group,and the differences were statistically significant(P＜0.05).There were no significant differences in the success rate of lithotripsis and calculi removal between the two groups(P＞0.05).The incidence of complications in the soft ureteroscope group was 6.25%,lower than 25.00%in the hard ureteroscope group,and the difference was statistically significant(P＜0.05).Conclusion Compared with holmium laser lithotripsy under hard ureteroscopy,holmium laser lithotripsy under flexible ureteroscopy is used in the treatment of complex upper ureteral calculi with less blood loss,less inflammatory reaction and higher safety.
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