CAJ | 학술논문

[目的]比较钬激光碎石术(Holmium :YAG laser lithotripsy ,LL )和气压弹道碎石术(Pneumatic lithotripsy ,PL)治疗上尿路结石合并急性肾功能不全的疗效及安全性.[方法]127例上尿路结石合并急性肾功能不全患者应用钬激光碎石治疗65例,气压弹道碎石治疗62例,对两种方法的疗效、安全性方面进行比较和评价.[结果]钬激光碎石组和气压弹道碎石组的结石一次粉碎率分别为83.08%和74.19%( P <0.05);平均手术时间前者(43.12±11.45)min 较后者短(53.31±14.18) min( P <0.05);平均术中出血量前者(34.39±12.36)mL 较后者少(47.82±12.08) mL( P <0.05);平均住院时间前者(4.27 ± 1.37) d 较后者短(5.63 ± 1.38) d( P <0.05);术后血尿素氮(BUN)和肌酐(CREA)恢复时间前者(6.93 ± 3.22) d 较后者短(8.32 ± 3.24) d ( P <0.05).随访1~3个月,无严重手术并发症.[结论]治疗上尿路结石合并肾功能不全钬激光较气压弹道碎石具有一定的优势,是一种安全有效的碎石方法.
[목적]비교화격광쇄석술(Holmium :YAG laser lithotripsy ,LL )화기압탄도쇄석술(Pneumatic lithotripsy ,PL)치료상뇨로결석합병급성신공능불전적료효급안전성.[방법]127례상뇨로결석합병급성신공능불전환자응용화격광쇄석치료65례,기압탄도쇄석치료62례,대량충방법적료효、안전성방면진행비교화평개.[결과]화격광쇄석조화기압탄도쇄석조적결석일차분쇄솔분별위83.08%화74.19%( P <0.05);평균수술시간전자(43.12±11.45)min 교후자단(53.31±14.18) min( P <0.05);평균술중출혈량전자(34.39±12.36)mL 교후자소(47.82±12.08) mL( P <0.05);평균주원시간전자(4.27 ± 1.37) d 교후자단(5.63 ± 1.38) d( P <0.05);술후혈뇨소담(BUN)화기항(CREA)회복시간전자(6.93 ± 3.22) d 교후자단(8.32 ± 3.24) d ( P <0.05).수방1~3개월,무엄중수술병발증.[결론]치료상뇨로결석합병신공능불전화격광교기압탄도쇄석구유일정적우세,시일충안전유효적쇄석방법.
Objective] To compare the efficacy and safety of Holmium :YAG laser lithotripsy (LL ) vs . pneumatic lithotripsy(PL) for the treatment of upper urinary calculi complicated with acute renal insufficiency .[Methods]Totally 127 cases of upper urinary calculi complicated with acute renal insufficiency underwent LL ( n = 65) or PL ( n = 62) ,respectively .The efficacy and safety were compared between two groups .[Results]The rates of one‐time fragmentation in LL group and PL group were 83 .08% and 74 .19% ,respectively( P <0 .05) .The average operation time of LL group was shorter than that of PL group [(43 .12 ± 11 .45)min vs . (53 .31 ± 14 .18)min ,P < 0 .05] .The average blood loss of LL group was less than that of PL group [(34 .39 ± 12 .36)ml vs .(47 .82 ± 12 .08)mL ,P < 0 .05] .The average hospitalization time of LL group was shorter than that of PL group[(4 .27 ± 1 .37)d vs .(5 .63 ± 1 .38)d ,P < 0 .05] .The recovery time of blood urea nitro‐gen(BUN) and creatine(CREA) after operation in LL group was shorter than that in PL group [(6 .93 ± 3 .22) d vs .(8 .32 ± 3 .24 )d , P < 0 .05] . No severe complication occurred during 1 ~ 3 months of follow‐up .[Conclusion] Compared with PL ,LL has more advantages in the treatment of upper urinary calculi .It is a safe and effective lithotripsy method .