[1]孟 涛,刘锦波,王纪科,等.输尿管硬镜钬激光碎石与后腹腔镜上段输尿管切开取石治疗输尿管结石疗效对比研究*[J].陕西医学杂志,2020,49(2):162-165.
　MENG Tao,LIU Jinbo,WANG Jike,et al.Analysis of efficacy of holmium laser ureteroscopic lithotripsy and retroperitoneal laparoscopic ureterolithotomy on ureteral calculi[J].,2020,49(2):162-165.
点击复制

输尿管硬镜钬激光碎石与后腹腔镜上段输尿管切开取石治疗输尿管结石疗效对比研究*
分享到：

《陕西医学杂志》[ISSN:1000-7377/CN:61-1281/TN]

卷:
49
期数:
2020年2期
页码:
162-165
栏目:
临床研究
出版日期:
2020-02-05

文章信息/Info

Title:
Analysis of efficacy of holmium laser ureteroscopic lithotripsy and retroperitoneal laparoscopic ureterolithotomy on ureteral calculi
文章编号:
DOI:〖HT5K〗10.3969/j.issn.10007377.2020.02.009
作者:
孟 涛1; 刘锦波1; 王纪科1; 王运起1; 汪 峰2
1.陕西省杨凌示范区医院泌尿外科(杨凌712100); 2.延安大学附属医院泌尿外科(延安716000)
Author(s):
MENG Tao; LIU Jinbo; WANG Jike; et al.
Department of Urology,Yangling Demonstration Zone Hospital,Shaanxi Province(Yangling 712100)
关键词:
输尿管结石;  治疗;  输尿管硬镜钬激光碎石;  后腹腔镜上段输尿管切开取石;  疗效;  并发症;  炎症反应
Keywords:
Ureteral calculi;  Therapy;  Holmium laser ureteroscopic lithotripsy;  Retroperitoneal laparoscopic ureterolithotomy;  Therapeutic effect;  Complication;  Inflammatory response
分类号:
R693.4
文献标志码:
A
摘要:
目的:探讨输尿管结石经钬激光输尿管碎石(URSL)与后腹腔镜上段输尿管切开取石(RLU)治疗的疗效。方法:回顾性分析38例行URSL的输尿管结石患者(观察组)和同期行RLU的38例输尿管结石患者的临床资料。比较两组结石清除率,两组围术期指标(手术时间、术中出血量、血尿持续时间、住院时间),术前、术后1 d评估两组炎症反应[白介素-1(IL-1)、肿瘤坏死因子-α(TNF-α)、白细胞(WBC)],记录两组术后并发症发生率。结果:①观察组结石清除率低于对照组(P<0.05); ②观察组手术时间、术中出血量、血尿持续时间、住院时间均低于对照组(P<0.05); ③术后1 d,两组IL-1、TNF-α、WBC均高于术前(P<0.05),观察组增幅小于对照组(P<0.05); ④两组尿路感染发生率对比差异无统计学意义(P>0.05),观察组术后皮下气肿、输尿管狭窄发生率均低于对照组(P<0.05)。结论:RLU和URSL均可用于治疗输尿管结石的治疗,但RLU结石清除率更高,URSL在控制术中损伤和术后并发症方面更有优势。
Abstract:
Objective:To explore the efficacy of holmium laser ureteroscopic lithotripsy(URSL)and retroperitoneal laparoscopic ureterolithotomy(RLU)on ureteral calculi.Methods:The clinical data of 38 patients with ureteral calculi who underwent holmium laser URSL(observation group)and 38 patients with ureteral calculi who underwent RLU at the same period were retrospectively analyzed.The stone clearance rate and perioperative indexes(operative time,intraoperative blood loss,hematuria duration,hospital stay)were compared between the two groups.The inflammatory reaction factors [interleukin-1(IL-1),tumor necrosis factor-α(TNF-α),white blood cell(WBC)] were evaluated in the two groups before surgery and one day after surgery,and the incidence rate of postoperative complications was recorded in the two groups.Results:The observation group had a lower stone clearance rate than the control group(P<0.05).The operative time,intraoperative blood loss,hematuria duration and hospital stay in observation group were lower than those in control group(P<0.05).One day after surgery,the IL-1,TNF-α and WBC in the two groups were higher than those before surgery(P<0.05),and the increases in observation group were smaller than those in control group(P<0.05).There was no significant difference in the incidence rate of urinary tract infection between the two groups(P>0.05),and the incidence rates of postoperative subcutaneous emphysema and ureterostenosis in observation group were lower than those in control group(P<0.05).Conclusion:Both RLU and holmium laser URSL can be used to treat ureteral calculi.But RLU have a higher clearance rate.Holmium laser URSL is more advantageous in controlling intraoperative injury and postoperative complications.

参考文献/References:

[1] 王施广,王 娟,王 振,等.泌尿系结石的流行病学研究进展[J].现代生物医学进展,2016,16(3):597-600.
[2] 崔 昕,欧彤文,何新洲,等.输尿管软镜与经皮肾镜处理嵌顿性输尿管上段结石疗效对比研究[J].陕西医学杂志,2018,47(2):193-195.
[3] 周家权,王 阳,徐从杰,等.腹腔镜与输尿管镜治疗输尿管上段结石临床疗效的Meta分析[J].现代泌尿外科杂志,2017,22(4):277-282.
[4] Eisel M,Strsbl S,Pongratz T,et al.In vitro investigations of propulsion during laser lithotripsy using video tracking[J].Lasers in Surgery and Medicine,2017,50(4):333-339.
[5] 李建友,王 胜,陈 蕊,等.输尿管镜下钬激光碎石术与开放手术治疗输尿管结石临床对照研究[J].实用心脑肺血管病杂志,2017,25(S1):26-27.
[6] 李文威.不同术式对复杂性输尿管上段结石治疗效果的比较[J].西南国防医药,2017,27(1):46-48.
[7] 杨立新,马凤巧,王 阳,等.后腹腔镜与输尿管镜技术治疗感染性输尿管上段结石患者后对其肾功能及其相关指标的影响[J].中华医院感染学杂志,2017,27(1):143-146.
[8] Zhang MC.Assessment of serum cytokines,stress horm-ones and oxidative stress indexes after tubeless PCNL treatment of upper ureteral calculi[J].Journal of Hainan Medical University,2017,23(10):63-66.
[9] 陈伟军.输尿管硬镜激光碎石和腹腔镜切开取石治疗输尿管上端结石的疗效和并发症的比较[J].实用临床医药杂志,2018,22(5):62-64.
[10] 陆 兵,江 俊,李 磊,等.软性输尿管镜钬激光碎石术与后腹腔镜输尿管切开取石术治疗输尿管上段结石的疗效[J].江苏医药,2017,43(3):200-202.
[11] 李志斌,何利兵,刘 红.复杂性上段输尿管结石患者采用三种腔镜手术的疗效对比[J].广东医学,2018,39(10):100-102.
[12] 任小强,程 涛,张建国.腹腔镜输尿管切开取石术治疗输尿管上段复杂性结石的应用研究[J].腹腔镜外科杂志,2018,23(2):135-139.
[13] 白志杰.钬激光在泌尿系统结石治疗中的应用进展[J].中国中西医结合外科杂志,2017,23(2):220-221.
[14] 刘 富,李质尚.输尿管硬镜联合N-Trap阻石篮钬激光碎石术治疗嵌顿性输尿管上段结石的疗效观察[J].浙江医学,2019,41(2):74-75,78.
[15] 李保安,何长海,赵 琪.N-Trap阻石网篮与封堵器在输尿管镜钬激光碎石术治疗输尿管上段结石中的应用比较[J].现代泌尿外科杂志,2018,23(1):30-33.
[16] 郭 涛,唐亚纯,符 浩,等.腔内钬激光碎石术在输尿管结石患者中的运用效果研究[J].中国现代医学杂志,2018,28(25):51-55.
[17] 韩生禄,刘海莲,赵留存,等.输尿管镜下气压弹道碎石术与钬激光碎石术治疗输尿管结石疗效对比研究[J].陕西医学杂志,2019,48(5):568-570.

相似文献/References:

[1]韩生禄,刘海莲△,赵留存,等.输尿管镜下气压弹道碎石术与钬激光碎石术治疗输尿管结石疗效对比研究*[J].陕西医学杂志,2019,(5):578.
　HAN Shenglu,LIU Hailian,ZHAO Liucun,et al.Effect comparison of pneumatic ballistic Lithotripsy and holmiumlaser lithotripsy in treatment of ureteral calculi through ureteroscope[J].,2019,(2):578.
[2]康 峰,杜丽娜△.输尿管镜钬激光碎石术与输尿管镜气压弹道碎石术〖JZ〗治疗输尿管结石临床对比研究*[J].陕西医学杂志,2019,(10):1275.
[3]李延喜,郭世文△.微创手术对高血压基底节脑出血患者生活质量及脑功能恢复效果的影响研究[J].陕西医学杂志,2020,49(2):166.
　LI Yanxi,GUO Shiwen..Effect of minimally invasive surgery on the quality of life and brain function recovery in patients with hypertensive basal ganglia hemorrhage[J].,2020,49(2):166.
[4]谢江涛,苏永永,吴鹏昌,等.显微镜联合神经内镜治疗颅内前循环破裂动脉瘤疗效研究[J].陕西医学杂志,2020,49(2):205.
[5]张静雯,汪 宁,邱红霞,等.非布司他治疗早期糖尿病肾病合并高尿酸血症疗效及对患者肾功能影响研究*[J].陕西医学杂志,2020,49(2):209.
　ZHANG Jingwen,WANG Ning,QIU Hongxia,et al.Efficacy of febuxostat on early diabetic nephropathy with hyperuricemia and its effect on renal function[J].,2020,49(2):209.
[6]姜 萌,赵 鹏△.奥曲肽联合加贝酯治疗重症急性胰腺炎疗效及对患者血清细胞因子水平的影响[J].陕西医学杂志,2020,49(2):212.
　JIANG Meng,ZHAO Peng..Clinical efficacy of octreotide combined with gabexate in the treatment of severe acute pancreatitis and its effect on serum cytokine levels[J].,2020,49(2):212.
[7]薛佩妮,冯敏娟△,王惠琴.噻托溴铵粉联合糖皮质激素治疗慢性阻塞性肺疾病疗效及对患者生活质量评分的影响*[J].陕西医学杂志,2020,49(2):216.
　XUE Peini,FENG Minjuan,WANG Huiqin..Efficacy of tiotropium bromide combined with glucocorticoids in the treatment of COPD and its effect on patients' quality of life score[J].,2020,49(2):216.
[8]王瑶君,王 岩△.色甘萘甲那敏鼻喷雾剂治疗急性非化脓性中耳炎疗效及对患者血清miR-203a和miR-155的影响[J].陕西医学杂志,2020,49(2):220.
　WANG Yaojun,WANG Yan..The efficacy of Shuntuomin in the treatment of acute non-suppurative otitis media and its effect on serum miR-203a and miR-155[J].,2020,49(2):220.
[9]刘 阳,许汴菊△.醋酸亮丙瑞林微球在子宫腺肌病合并不孕患者行体外受精-胚胎移植治疗中的应用*[J].陕西医学杂志,2020,49(2):223.
　LIU Yang,XU Bianju..Application of Leuprolide acetate microsphere in the treatment of adenomyosis combined with infertility in patients undergoing IVF-ET[J].,2020,49(2):223.
[10]关艳杰.中重度宫腔粘连病因及治疗研究进展[J].陕西医学杂志,2020,49(2):254.

备注/Memo

备注/Memo:
*延安大学校级青年科研项目(YDQ2016-30)
更新日期/Last Update: 2020-03-25