电子输尿管软镜钬激光碎石术治疗老年患者直径＜2 cm的肾结石的效果
Effect of electronic ureteroscopy holmium laser lithotripsy in the treatment of kidney stones with a diameter less than 2 cm in old patients
越宇1
作者信息
- 1. 广州中医药大学金沙洲医院 泌尿外科,广东 广州 510000
- 折叠
摘要
目的 探讨电子输尿管软镜钬激光碎石术治疗直径＜2 cm的老年肾结石的临床疗效.方法 回顾性分析2021年4月至2023年4月广州中医药大学金沙洲医院收治的85例直径＜2 cm的老年肾结石患者的临床资料,按手术方式分为对照组(n=42)与观察组(n=43),分别采用传统纤维输尿管软镜钬激光碎石术和电子输尿管软镜联合钬激光碎石术.对比两组围手术期指标、手术成功率、结石清除率、肾功能指标及并发症发生情况.结果 观察组手术时间及术中出血量分别为(70.26±14.35)min和(63.65±13.74)ml,明显低于对照组的(81.34±13.92)min和(76.47±15.16)ml,差异有统计学意义(P＜0.05);观察组结石清除率(95.35％)高于对照组(80.95％),差异有统计学意义(P＜0.05);两组患者的手术成功率及术后住院时间差异无统计学意义(P＞0.05);术后 24 h两组尿肾损伤分子-1(kidney injury molecule-1,KIM-1)、胱抑素 C(cystatin C,Cys-C)及中性粒细胞明胶酶相关载脂蛋白(neutrophil gelatinase associated lipocalin,NGAL)水平较术前明显升高,差异有统计学意义(P＜0.05),但两组间比较差异无统计学意义(P＞0.05);观察组血尿、发热等并发症发生率(4.65％)低于对照组(19.05％),差异有统计学意义(P＜0.05).结论 电子输尿管软镜联合钬激光碎石治疗与纤维输尿管软镜钬激光碎石治疗直径＜2 cm的老年肾结石患者手术成功率相当,均对患者肾功能损伤较小,但电子输尿管软镜手术结石清除率更高,手术时间与术中出血量更少,安全性高.
Abstract
Objective To investigate the effect of electronic ureteroscopy combined with holmium laser lithotripsy in the treatment of kidney stones with a diameter less than 2 cm in the elderly.Method Totally 85 elderly patients with kidney stones with a diameter less than 2 cm who were admitted to Jinshazhou Hospital,Guangzhou University of Traditional Chinese Medicine from April 2021 to April 2023 were retrospectively selected and grouped according to surgical methods.The control group(42 cases)was treated with traditional fiber ureteral soft mirror holmium laser lithotripsy,and the observation group(43 cases)was treated with electronic ureteral soft mirror combined with holmium laser lithotripsy.The perioperative indicators,surgical success rate,stone clearance rate,and complications of the two groups were compared.Results The surgical time(70.26±14.35)min and intraoperative bleeding volume(63.65±13.74)ml in the observation group were significantly lower than(81.34±13.92)ml and(63.65±13.74)ml in the control group(P＜0.05).The stone clearance rate of 95.35％in the observation group was significantly higher than 80.95％in the control group(P＜0.05).However,there was no significant difference in the surgical success rate and postoperative hospital stay between the two groups(P＞0.05).At 24 hours after surgery,the levels of urinary kidney injury molecule-1(KIM-1),cystatin C(Cys-C),and neutrophil gelatinase associated apolipoprotein(NGAL)in the two groups were significantly increased compared to those before surgery(P＜0.05),while there was no significant difference between the two groups(P＞0.05).The incidence of complications such as hematuria and fever in the observation group was 4.65％,significantly lower than 19.05％in the control group(P＜0.05).Conclusion The success rate of electronic ureteroscopy combined with holmium laser lithotripsy is comparable to that of fiber ureteroscopy combined with holmium laser lithotripsy in the treatment of kideny stones with a diameter less than 2 cm in elderly patients,both of which have less damage to the patient's renal function.However,electronic ureteroscopy has a higher stone clearance rate,less surgical time and intraoperative bleeding,and is safer.
关键词
肾结石/电子输尿管软镜/钬激光碎石术Key words
Kidney stones/Electronic ureteroscope/Holmium laser lithotripsy引用本文复制引用
出版年
2024
NETL
NSTL
万方数据