输尿管镜钬激光碎石术在膀胱憩室结石中的应用效果
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摘要
目的探讨输尿管镜钬激光碎石术(HLL)在膀胱憩室结石中的临床疗效。方法将我院2013年8月至2015年8月收治的膀胱憩室结石患者98例,按照碎石手段不同分为研究组(n=49)和对照组(n=49)。研究组采取HLL治疗,对照组采用气压弹道碎石术(PL)治疗,观察两组患者的临床疗效,并记录两组患者手术时间、术中失血量、一次性碎石率、术后2个月结石排净率以及并发症情况等指标。结果两组患者通过不同的方式治疗,结果显示,研究组的总有效率97.9%(48/49)明显高于对照组79.6%(39/49),组间比较差异具有统计学意义(P<0.05)。研究组的一次性碎石率和术后2个月结石排净率分别为91.83%和95.91%,明显高于对照组的77.55%和79.59%,组间比较差异有统计学意义(P<0.05)。研究组的手术时间明显比对照组短,差异存在统计学意义(P<0.05);研究组与对照组的术中失血量相比,无明显差异(P>0.05);与对照组的并发症发生率相比,研究组明显低于对照组(P<0.05)。结论与PL治疗技术相比,HLL技术治疗膀胱憩室结石效果显著,能够提高结石清除率,缩短其手术时长且减少并发症的发生率,值得推广应用。
Objective To explore the clinical efficacy of ureteroscopic holmium laser lithotripsy(HLL)in the treatment of bladder diverticular calculi.Methods A total of 98 patients with bladder diverticular calculi treated during Aug.2013 and Aug.2015 were divided into the study group and the control group,with 49 cases in either group.Patients in the study group were treated with HLL,and patients in the control group were treated with pneumatic lithotripsy.The operation time,blood loss,one-time lithotripsy rate,stone-free rate 2 months after operation,complications,and clinical efficacy of the 2 groups were compared.Results The total effective rate of the study group(97.9%)was significantly higher than that of the control group(79.6%)(P<0.05).The one-time lithotripsy rate and stone-free rate 2 months after operation of the study group were91.83% and 95.91%,which were significantly higher than those of the control group(77.55% and79.59%)(P<0.05).The operation time of the study group was significantly shorter than that of the control group(P<0.05).The incidence of complications of the study group was significantly lower than that of the control group(P<0.05).There was no significant difference in blood loss(P>0.05);Conclusion Compared with pneumatic lithotripsy,HLL is more effective in the treatment of bladder diverticular calculi,with higher stone clearance rate,shorter operation time and fewer complications.It is worth popularizing and applying.
Objective To explore the clinical efficacy of ureteroscopic holmium laser lithotripsy(HLL)in the treatment of bladder diverticular calculi.Methods A total of 98 patients with bladder diverticular calculi treated during Aug.2013 and Aug.2015 were divided into the study group and the control group,with 49 cases in either group.Patients in the study group were treated with HLL,and patients in the control group were treated with pneumatic lithotripsy.The operation time,blood loss,one-time lithotripsy rate,stone-free rate 2 months after operation,complications,and clinical efficacy of the 2 groups were compared.Results The total effective rate of the study group(97.9%)was significantly higher than that of the control group(79.6%)(P<0.05).The one-time lithotripsy rate and stone-free rate 2 months after operation of the study group were91.83% and 95.91%,which were significantly higher than those of the control group(77.55% and79.59%)(P<0.05).The operation time of the study group was significantly shorter than that of the control group(P<0.05).The incidence of complications of the study group was significantly lower than that of the control group(P<0.05).There was no significant difference in blood loss(P>0.05);Conclusion Compared with pneumatic lithotripsy,HLL is more effective in the treatment of bladder diverticular calculi,with higher stone clearance rate,shorter operation time and fewer complications.It is worth popularizing and applying.
引文
[1]于民,李娜.输尿管镜下钬激光与气压弹道碎石的疗效比较[J].中国医学创新,2015,12(11):122-124.
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[5]杨春,高小峰,周铁,等.输尿管软镜钬激光碎石术治疗合并临床症状的肾盏憩室结石[J].中华泌尿外科杂志,2012,33(1):16-18.
[6]程跃,马建伟,余瑛瑛,等.输尿管软镜钬激光碎石术治疗肾结石对肾功能的影响[J].中华泌尿外科杂志,2012,33(10):774-777.
[7]熊林,邹茜,余书勇,等.输尿管镜钬激光碎石术治疗输尿管结石120例[J].中国内镜杂志,2012,18(5):533-535.
[8]余丰,黄旭锋,罗怀景,等.输尿管镜碎石取石术治疗小儿输尿管中下段结石32例报告[J].现代泌尿外科杂志,2013,18(4):397-398.
[9]尤平洪,谭锐,戴庆德,等.输尿管镜下钬激光和气压弹道治疗输尿管上段结石的疗效比较[J].西部医学,2012,24(2):276-277.
[10]傅荣升.输尿管镜气压弹道碎石在泌尿系结石患者中的应用价值研究[J].中国医学创新,2013,10(29):50-51.
[2]杨震宇,盛畅,谢平,等.输尿管镜下钬激光碎石治疗输尿管膀胱壁段结石[J].临床泌尿外科杂志,2011,26(11):868-869.
[3]蔡海建,周宏,盛佳雁,等.输尿管镜钬激光碎石术治疗输尿管结石疗效观察(附498例报告)[J].国际泌尿系统杂志,2013,33(4):489-491.
[4]李远伟,吴万瑞,刘哲,等.输尿管软镜下钬激光碎石治疗输尿管上段结石伴肾功能不全的临床研究[J].国际泌尿系统杂志,2014,34(6):802-804.
[5]杨春,高小峰,周铁,等.输尿管软镜钬激光碎石术治疗合并临床症状的肾盏憩室结石[J].中华泌尿外科杂志,2012,33(1):16-18.
[6]程跃,马建伟,余瑛瑛,等.输尿管软镜钬激光碎石术治疗肾结石对肾功能的影响[J].中华泌尿外科杂志,2012,33(10):774-777.
[7]熊林,邹茜,余书勇,等.输尿管镜钬激光碎石术治疗输尿管结石120例[J].中国内镜杂志,2012,18(5):533-535.
[8]余丰,黄旭锋,罗怀景,等.输尿管镜碎石取石术治疗小儿输尿管中下段结石32例报告[J].现代泌尿外科杂志,2013,18(4):397-398.
[9]尤平洪,谭锐,戴庆德,等.输尿管镜下钬激光和气压弹道治疗输尿管上段结石的疗效比较[J].西部医学,2012,24(2):276-277.
[10]傅荣升.输尿管镜气压弹道碎石在泌尿系结石患者中的应用价值研究[J].中国医学创新,2013,10(29):50-51.