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钬激光与气压弹道治疗输尿管上段嵌顿性结石的疗效分析

Analysis of the efficacy of holmium laser and pneumatic ballistic in the treatment of impacted ureteral calculi.

作者信息

Chunlin Yang, Wanlin Du, Jinhua Du

机构信息

Department of Urology, Yuechi People's Hospital, Guang'an, Sichuan, China.

出版信息

Medicine (Baltimore). 2020 Sep 4;99(36):e21692. doi: 10.1097/MD.0000000000021692.

Abstract

To explore the safety and effectiveness of ureteroscopic holmium laser lithotripsy (UHLL) and ureteroscopic pneumatic lithotripsy (UPL) in the treatment of impacted ureteral calculi (IUC).Clinical data of 280 patients in our hospital from April 2016 to May 2019 were retrospectively collected and analyzed, including 136 cases of UHLL group and 144 cases of UPL group. The general clinical data, operation time, intraoperative bleeding volume, hospital stay, stone-free rate (SFR), and surgical complications were collected and analyzed in 2 group.Compared with UPL group, the operation time of UHLL group was significantly reduced (27.25 ± 8.39 vs 34.32 ± 10.57, P < .05), but the hospitalization cost was significantly increased (9.25 ± 0.75 vs 8.24 ± 0.51, P < .05). In terms of total SFR, the UHLL group was significantly higher than the UPL group (93.38% vs 83.33%, P = .011). For proximal IUC, compared with the UPL group, the SFR of the UHLL group was significantly increased (88.33% vs 70.31%, P = 0.005). For distal IUC, there was no significant difference in SFR (97.37% vs 93.75%, P = .638) between the UHLL group and UPL group. There were no significant differences in the complications of local mucosal injury, hematuria, febrile urinary tract infection, ureteral perforation, and urinary sepsis in the 2 groups (P > .05). However, the UHLL group was significantly lower in stone residual rate than the UPL group (6.61% vs 16.67%, P = .001).This study found that UHLL and UPL are safe and effective in the treatment of IUC, but UHLL has the advantages of shorter operation time and high SFR in the treatment of IUC.

摘要

探讨输尿管镜钬激光碎石术(UHLL)与输尿管镜气压弹道碎石术(UPL)治疗嵌顿性输尿管结石(IUC)的安全性和有效性。回顾性收集并分析我院2016年4月至2019年5月280例患者的临床资料,其中UHLL组136例,UPL组144例。收集并分析两组患者的一般临床资料、手术时间、术中出血量、住院时间、结石清除率(SFR)及手术并发症。与UPL组相比,UHLL组手术时间显著缩短(27.25±8.39 vs 34.32±10.57,P<0.05),但住院费用显著增加(9.25±0.75 vs 8.24±0.51,P<0.05)。在总SFR方面,UHLL组显著高于UPL组(93.38% vs 83.33%,P = 0.011)。对于近端IUC,与UPL组相比,UHLL组的SFR显著提高(88.33% vs 70.31%,P = 0.005)。对于远端IUC,UHLL组与UPL组的SFR无显著差异(97.37% vs 93.75%,P = 0.638)。两组局部黏膜损伤、血尿、发热性尿路感染、输尿管穿孔及尿脓毒症等并发症无显著差异(P>0.05)。然而,UHLL组的结石残留率显著低于UPL组(6.61% vs 16.67%,P = 0.001)。本研究发现,UHLL和UPL治疗IUC均安全有效,但UHLL在治疗IUC方面具有手术时间短和SFR高的优势。

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