【摘要】 目的:探讨"一步法"输尿管软镜取石术联合激光碎石术治疗老年嵌顿性输尿管上段结石患者的临床效果。方法:选取2019年1月-2020年6月本院收治的66例老年嵌顿性输尿管上段结石患者,按照随机数字表法将其分为对照组和治疗组,每组33例。两组均行输尿管软镜取石术联合激光碎石术治疗,治疗组行"一步法"治疗,对照组行"分步法"治疗。比较两组手术情况、血清指标、术后并发症发生情况及疼痛程度。结果:治疗组结石清除率为90.91%,高于对照组的81.82%,但差异无统计学意义(P>0.05)。治疗组术后住院时间、手术时间均短于对照组,差异均有统计学意义(P<0.05)。术前,两组Scr、BUN、CRP水平比较,差异均无统计学意义(P>0.05)。术后48 h,两组Scr、BUN水平均高于术前,治疗组均低于对照组,但差异均无统计学意义(P>0.05)。术后48 h,两组CRP水平均高于术前,但治疗组CRP低于对照组,差异均有统计学意义(P<0.05)。治疗组术后24 h疼痛程度轻于对照组,差异有统计学意义(P<0.05)。治疗组并发症发生率低于对照组,差异有统计学意义(P<0.05)。结论:老年嵌顿性输尿管上段结石患者行"一步法"输尿管软镜取石术联合激光碎石术治疗具有手术时间短、并发症少、疼痛轻、住院时间短等优点,且利于减轻炎性反应,值得临床推广。更多还原

【Abstract】 Objective:To explore the clinical effect of “one-step” flexible ureteroscope lithotripsy combined with laser lithotripsy in the treatment of elderly patients with incarcerated upper ureteral calculi.Method:A total of 66 elderly patients with incarcerated upper ureteral calculi admitted to our hospital from January 2019 to June 2020 were selected,they were divided into two control group and treatment group according to random number table,33 cases in each group.Both groups were treated with flexible ureteroscope lithotripsy combined with laser lithotripsy,the treatment group received the “one-step” treatment,and the control group received the “step-by-step” treatment.The surgery status,serum index,postoperative complications,and pain degree were compared between two groups.Result:The stone clearance rate in the treatment group was 90.91%,which was higher than 81.82% in the control group,but the difference was not statistically significant (P>0.05).The postoperative hospitalization time and surgical time in the treatment group were shorter than those in the control group,the differences were statistically significant (P<0.05).Before surgery,there were no significant differences in Scr,BUN and CRP levels between two groups (P>0.05);48 h after surgery,the levels of Scr and BUN in the both groups were higher than those before surgery,and those in the treatment group were lower than those in the control group,but the differences were not statistically significant (P>0.05).48 h after surgery,CRP level in both groups were higher than before surgery,but CRP level in treatment group was lower than that in the control group,the differences were statistically significant (P<0.05).The pain degree in the treatment group was lighter than that in the control group at 24 h after surgery,the difference was statistically significant (P<0.05).The incidence of complications in the treatment group was lower than that in the control group,the difference was statistically significant (P<0.05).Conclusion:The “one-step” flexible ureteroscope lithotripsy combined with laser lithotripsy for elderly patients with incarcerated upper ureteral calculi has the advantages of short surgical time,fewer complications,less pain,and shorter hospital stay,and it is beneficial to reduce inflammatory reactions,which is worthy of clinical promotion.更多还原