腔内钬激光碎石术在输尿管结石患者中的 运用效果研究

Effect of holmium laser lithotripsy on patients with ureteral calculi

摘要:

目的 研究腔内钬激光碎石术（HLL）对输尿管结石的手术效果、炎症因子及氧化应激指标的影响。 方法 选取南华大学附属南华医院2015 年10 月-2017 年2 月收治的输尿管结石患者86 例，采用随机数字表 法分为对照组和观察组，每组各43 例。对照组患者接受气压弹道碎石术（PL）治疗，观察组患者接受HLL 治疗。比较两组患者的手术时间、住院时间、即刻清石率、1 个月清石率、血尿消失时间及并发症发生率， 同时比较两组患者手术前后的氧化应激指标和炎症因子、肾功能指标变化。结果 观察组与对照组的手术时 间、住院时间及血尿消失时间比较，差异有统计学意义（P <0.05），观察组短于对照组；观察组与对照组的即 刻清石率比较，差异有统计学意义（P <0.05），观察组高于对照组；观察组与对照组术后的血清Cor、MDA、 GSHpx、IL-2、IL-6、IL-10、TNF-α、Scr 及BUN 水平比较，差异有统计学意义（P <0.05），观察组低于 对照组，血清SOD 水平高于对照组；两组患者的总并发症发生率比较差异无统计学意义（P >0.05）。结论 HLL 治疗输尿管结石具有结石排出率高、术后恢复快、并发症少等优势，且降低手术对机体的氧化应激和炎 症反应，值得在临床推广。

Abstract:

Objective To study the influence of endoscopic holmium: YAG laser lithotripsy (HLL) on the operation effect and inflammatory factors and oxidative stress indexes of ureteral calculi. Methods The subjects were 86 patients with ureteral calculi in our hospital from October 2015 to February 2017, they were randomly divided into a control group and an observation group, each group had 43 cases. The control group received pneumatic lithotripsy (PL) treatment, and the observation group was treated with HLL. The operation time, hospitalization time, immediate stone clearance rate, 1-month stone clearance rate and hematuria disappearance time and incidences of complications were compared between the two groups, and the changes of the oxidative stress indexes, inflammatory factors and renal function indexes were also compared between the two groups. Results The operation time, hospitalization time and hematuria disappearance time in the observation group were significantly shorter than those in the control group (P < 0.05). The immediate stone clearance rate of the observation group was significantly higher than that of the control group (P < 0.05). The postoperative serum Cor, MDA, GSHpx, IL-2, IL-6, IL-10, TNF-α, Scr and BUN levels of the observation group were significantly lower than those of the control group (P < 0.05), the serum level of SOD was higher than that of the control group (P < 0.05). The total incidence of complications of the two groups had no significant difference (P > 0.05). Conclusions HLL treatment has the advantages of high stone expulsion rate of ureteral calculi, fast postoperative recovery and few complications, and can reduce the oxidative stress and inflammatory reaction of the operation to the body. It is worthy of clinical application.