摘要
目的 探讨输尿管镜钬激光碎石术(ureteroscopic holmium laser lithotripsy,UHL)在清除老年复杂输尿管上段结石中的临床效果.方法 选取2021年1月至2023年7月安徽省马鞍山和县人民医院收治的66例老年复杂输尿管上段结石患者作为研究对象,按照随机数字表法分为研究组与对照组,每组33例.对照组采用气压弹道碎石术治疗,研究组采用UHL治疗.比较两组手术相关指标、临床疗效、手术前后肾功能、并发症发生率.结果 研究组手术、住院时间均短于对照组,术中出血量低于对照组,差异有统计学意义(P＜0.05);研究组结石清除率(96.97％)高于对照组(81.82％),差异有统计学意义(P＜0.05).研究组临床总有效率(96.97％)高于对照组(78.79％),差异有统计学意义(P＜0.05).治疗前,两组血肌酐、血尿素氮比较,差异无统计学意义(P＞0.05);治疗后,两组血肌酐、血尿素氮均低于治疗前,且研究组低于对照组,差异有统计学意义(P＜0.05).两组并发症总发生率比较(24.24％vs.6.06％),差异无统计学意义(P＞0.05).结论 UHL治疗老年复杂输尿管上段结石患者疗效明确,可改善术后肾功能,且不会增加术后并发症发生率.
Abstract
Objective To explore the clinical effect of ureteroscopic holmium laser lithotripsy(UHL)on stone clearance in elderly patients with complex proximal ureteral calculi.Methods A total of 66 elderly patients with complex proximal ureteral calculi in He County People's Hospital were enrolled as the research objects between January 2022 and July 2023.According to random number table method,patients were divided into the study group(n=33)and control group(n=33).The control group was treated with pneumatic lithotripsy,and the study group was treated with UHL.The operation-related indexes,clinical efficacy,serum creatinine,blood urea nitrogen,and the incidence of complications were compared between the study group and the control group.Results The operation time and length of hospital stay in study group were shorter than those in control group,and intraoperative blood loss was less than that in control group(P＜0.05).The stone clearance rate and total clinical effective rate in the treatment group were significantly higher than those in the control group(stone clearance rate:96.97％vs.81.82％;clinical effective rate:96.97％vs.78.79％;all P＜0.05).After treatment,the levels of serum creatinine and blood urea nitrogen in the study group were significantly lower than those in the control group(P＜0.05).There was no significant difference in the total incidence of complications between the control group and the study group(24.24％vs.6.06％,P＞0.05).Conclusion The curative effect of UHL is significant in elderly patients with complex proximal ureteral calculi,which can improve postoperative renal function and reduce incidence of postoperative complications.
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