输尿管软镜钬激光碎石术治疗输尿管上段大结石的效果观察_张展.pdf

2023 年 2 月第 30 卷第 2 期输尿管软镜钬激光碎石术治疗输尿管上段大结石的效果观察张展，李永强，李宏州（郑州颐和医院 泌尿外科，河南 郑州450046）【摘要】目的 探讨输尿管软镜钬激光碎石术（FURL）治疗输尿管上段大结石的效果。方法80例输尿管上段大结石患者随机分为两组各40例，对照组采用经皮肾镜取石术（PCNL）治疗，观察组采用FURL治疗，比较两组的手术指标、结石清除效果、并发症。结果观察组的手术时间长于对照组，但术中出血量少于对照组，住院时间短于对照组（P 0.05）。观察组的结石清除率高于对照组，并发症发生率低于对照组（P 0.05）。结论FURL治疗输尿管上段大结石虽然会延长手术时间，但具有术中出血量更少、住院时间更短、结石清除率更高、并发症发生率更低等优势。【关键词】输尿管上段大结石；输尿管软镜钬激光碎石术；并发症中图分类号：R693+.4文献标识码：Adoi:10.3969/j.issn.1674-4659.2023.02.0153Observation on the Effect of Flexible Ureteroscopic Holmium Laser Lithotripsy in the Treatment of Large Upper UreteralCalculi/ZHANG Zhan,LI Yongqiang,LI Hongzhou(Department of Urology,Zhengzhou Yihe Hospital,Zhengzhou 450046,China)AbstractObjective To explore the effect of flexible ureteroscopic holmium laser lithotripsy(FURL)in the treatment of large upperureteral calculi.Methods 80 patients with large upper ureteral calculi were randomly divided into two groups,with 40 cases in each group.The control group was treated with percutaneous nephrolithotomy(PCNL),and the observation group was treated with FURL.The surgicalindicators,stone clearance effect and complications were compared between the two groups.Results The operation time of the observationgroup was longer than that of the control group,but the intraoperative blood loss amount was less than that of the control group,and thehospitalization time was shorter than that of the control group(P 0.05).The stone clearance rate of the observation group was higher thanthatofthecontrolgroup,andtheincidenceofcomplicationswaslowerthanthatofthecontrolgroup(P1 cm输尿管上段结石的疗效比较J.中国内镜杂志,2019,25(6):62-66.2范学勇.微创经皮肾镜与输尿管软硬镜联合治疗输尿管上段复杂结石的疗效对比J.河北医学,2019,25(12):2022-2025.3张慕淳,谷安娜,赵志易.输尿管软镜碎石术联合微创经皮肾镜取石术治疗嵌顿性输尿管上段结石的疗效及安全性分析J.微创泌尿外科杂志,2019,8(5):314-318.4赵文超,郑明华,李文琦,等.微创经皮肾镜碎石术与输尿管软镜碎石术在治疗直径大于1 cm输尿管上段结石的临床疗效对比J.微创泌尿外科杂志,2019,8(1):21-24.5吴文斌,钟金森,党瑞锋,等.一种改良的输尿管硬镜技术在输尿管上段结石治疗中的应用J.中华全科医学,2019,17(8):1257-1260.6侯玉龙,李海龙,陈跃,等.输尿管切开取石术与输尿管钬激光碎石术在嵌顿性输尿管上段结石疗效比较J.国际泌尿系统杂志,2021,41(3):458-461.7董晓飞,蒋吉高,汪超军.输尿管软镜钬激光碎石术治疗体外冲击波碎石术失败的输尿管上段结石J.临床泌尿外科杂志,2019,34(6):463-465.8王鹏,冷国雄,权良明.输尿管软镜钬激光碎石与部分无管化经皮肾镜钬激光碎石术对上尿路结石促进患者术后康复的效果对比J.河北医学,2020,26(12):2008-2012.组别n手术时间（min）术中出血量（mL）住院时间（d）观察组4047.395.4321.342.983.470.85对照组4043.274.8532.463.676.351.09t3.57914.87713.178P0.0010.0000.000组别n残存1块结石残存多块结石无残存清除率观察组402（5.00）0（0.00）38（95.00）38（95.00）对照组405（12.50）3（7.50）32（80.00）32（80.00）2-4.114P-0.043组别n发热寒战泌尿系统刺激症状合计观察组402（5.00）1（2.50）0（0.00）3（7.50）对照组405（12.50）2（5.00）3（7.50）10（25.00）2-4.501P-0.034（责任编辑：常海庆）154