Effects of flexible ureteroscopic Holmium laser lithotripsy in treatment of patients with upper ureteral calculi
Objective:To observe effects of flexible ureteroscopic holmium laser lithotripsy in the treatment of patients with upper ureteral calculi.Methods:A prospective study was conducted on 92 patients with upper ureteral calculi admitted to this hospital from June 2020 to June 2023.According to the random number table method,they were divided into study group and control group,46 cases in each group.The control group was treated with percutaneous nephrolithotomy,while the study group was treated with flexible ureteroscopic Holmium laser lithotripsy.The stone clearance rate,the postoperative recovery time,the urinary function indexes[postoperative residual urine volume(RUV),maximum urinary flow rate,maximum urethral pressure(MUP)]levels before and after the surgery,the oxidative stress indexes[epinephrine(E),cortisol(Cor)]levels 1 and 7 days after the surgery,and the incidence of complications were compared between the two groups.Results:The stone clearance rate of the study group was 89.13%(41/46),which was higher than 71.74%(33/46)of the control group,and the difference was statistically significant(P＜0.05).7 days after the surgery,the first out-of-bed time,the operation time and the hospitalization time in the study group were shorter than those in the control group,and the differences were statistically significant(P＜0.05).7 days after the surgery,the maximum urinary flow rate and the MUP level in the two groups were higher than those 1 day before the surgery,and those in the study group were higher than those in the control group;the RUV of the two groups were lower than before the surgery,and that in the study group was lower than that in the control group;and the differences were statistically significant(P＜0.05).7 days after the surgery,The levels of E and Cor in the two groups were lower than those 1 d after the surgery,those in the study group were lower than those in the control group,and the differences were statistically significant(P＜0.05).Further,the incidence of complications in the study group was 8.70%(4/46),which was lower than 23.91%(11/46)in the control group,and the difference was statistically significant(P＜0.05).Conclusions:Flexible ureteroscopic Holmium laser lithotripsy for the patients with upper ureteral calculi can improve the stone clearance rate,shorten the postoperative recovery time,improve the levels of urinary function indexes,and reduce the levels of oxidative stress indexes and the incidence of complications.Moreover,it is superior to percutaneous nephrolithotomy.
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