Comparisons of the curative effect of ureteroscopic cold laser lithotripsy and holmium laser lithotripsy in the treatment of renal calculi

doi:10.3877/cma.j.issn.1674-3253.2020.02.008

Abstract

Abstract:

Objective

To compare the clinical efficacy of ureteroscopic cold laser lithotripsy and holmium laser lithotripsy in the treatment of renal calculi.

Methods

Clinical data of 192 patients with renal calculi from January 2015 to January 2018 in Zhangzhou Hospital of Traditional Chinese Medicine were analyzed retrospectively. According to the surgical method they were divided into observation group (n=98, cold laser lithotripsy with flexible ureteroscope) and control group(n=94, holmium laser lithotripsy with flexible ureteroscope). The operation related indexes, curative effect and complications were compared between the two groups.

Results

The operation time, intraoperative bleeding volume, complication rate and stone clearance rate of the observation group were significantly better than those of the control group, the difference was significant(P<0.05).

Conclusion

Ureteroscopy combined with cold laser lithotripsy is safe and effective in the treatment of renal calculi. Compared with traditional methods, it has rationality and superiority and is worthy of clinical recommendation.

Key words: Flexible ureteroscope, Cool laser, Lithotripsy, Renal calculi, Retrospective study

Haibing Chen, Lidan Luo, Zhimou Wang. Comparisons of the curative effect of ureteroscopic cold laser lithotripsy and holmium laser lithotripsy in the treatment of renal calculi[J]. Chinese Journal of Endourology(Electronic Edition), 2020, 14(02): 112-115.

/ / Recommend

Add to citation manager EndNote|Ris|BibTeX

URL: https://zhqjmnmwkzz.cma-cmc.com.cn/EN/10.3877/cma.j.issn.1674-3253.2020.02.008

https://zhqjmnmwkzz.cma-cmc.com.cn/EN/Y2020/V14/I02/112

Figures/Tables 3

References 25

[1]	郝继东，廖国强，刘辉, 等. 经皮肾镜钬激光碎石术与体外冲击波碎石术治疗肾结石的效果[J]. 河北医学, 2016, 22(1): 20-23.
[2]	王亮，杨伟，曹文锋, 等. 后腹腔镜联合胆道镜治疗嵌顿性输尿管上段结石及肾结石的临床应用[J]. 中国内镜杂志, 2015, 21(2): 196-198.
[3]	冷松柏，钟毅，黄明, 等. 输尿管软镜与微通道经皮肾镜治疗肾结石（≤2 cm ）的比较[J/CD]. 中华腔镜泌尿外科杂志(电子版), 2017, 11(1): 38-41.
[4]	王磊，徐学军，尹海军, 等. 微创经皮肾镜钬激光碎石术与开放性肾切开取石术治疗复杂性肾结石临床疗效比较[J]. 中国内镜杂志, 2014, 20(1): 72-75.
[5]	彭泳涵，施晓磊，刘敏, 等. 输尿管软镜钬激光碎石术在孤立肾合并肾结石患者中的应用:单中心107例报告[J]. 临床泌尿外科杂志, 2018, 7(33): 516-519.
[6]	Schnabel MJ, Gierth M, Chaussy CG, et al. Incidence and risk factors of renal hematoma: a prospective study of 1 300 SWL treatments[J].Urolithiasis, 2014, 42(3): 247-253.
[7]	曾国华，买赞林，袁坚, 等. PCNL治疗上尿路结石：单中心10 452例19年经验报告[J]. 中华泌尿外科杂志, 2012, 33(10): 767-770.
[8]	Kohlany M, Shokeir A, Mosbah A, et al.Treatmtent of complete staghorn stones: a prospective randomized comparison of open surgery versus percutaneous nephrolithotomy[J]. J Urol, 2005, 173(2): 469-473．
[9]	Van Savage JG, Palmaea LG, Andersen RD, et a1. Treatment of distal ureteral stones in children：similarities to the american urological association guidelines in adults[J]. J Urol, 2000, 164(2): 1089-1093.
[10]	李建伟，王芳，蔡芳震, 等. 分期输尿管软镜钬激光碎石术与微通道经皮肾镜碎石术治疗2～4 cm肾结石的随机对照临床研究[J]. 南方医科大学学报, 2016, 36(12): 1672-1676.
[11]	马海，李杨，周文奇, 等. 输尿管软镜钬激光碎石术治疗上尿路结石(附86例报告)[J]. 中国微创外科杂志, 2017, 6(17): 565-567.
[12]	高小峰，彭泳涵. 输尿管软镜碎石术的操作技巧[J/CD]. 中华腔镜泌尿外科杂志(电子版), 2015, 9(1): 1-4．
[13]	钟键，卞卫星，仇佳星, 等. 输尿管软镜与微通道经皮肾镜治疗2～3 cm肾盂结石的疗效分析[J/CD]. 中华腔镜泌尿外科杂志(电子版), 2018, 12(3): 202-205.
[14]	赵海波. 经皮肾镜碎石取石术与输尿管软镜钬激光碎石术治疗肾结石患者的临床疗效比较[J]. 临床合理用药, 2018, 7(11): 149-150
[15]	吴猛，刘良兵，易东风. 软性输尿管镜钬激光碎石术与经皮肾镜碎石取石术治疗直径≤2 cm肾结石5年回顾性分析[J]. 临床外科杂志, 2017, 6(25): 469-471.
[16]	杨嗣星，宋超，刘凌琪, 等. 输尿管镜下钬激光碎石与经皮肾镜取石术治疗肾结石的疗效比较[J]. 中华泌尿外科杂志, 2013, 9(34): 666-669.
[17]	Turna B, Stein RJ, Smaldone MC, et al. Safety and efficacy of flexible ureterorenoscopy and holmium: YAG lithotripsy for intrarenal stones in anticoagulated cases[J]. J Urol, 2008, 179(4): 1415-1419．
[18]	Geraghty RM, Ishii H, Somani BK. Outcomes of flexible ureteroscopy and laser fragmentation for treatment of large renal stones with and without the use of ureteral access sheaths:Results from a university hospital with a review of literature[J]. Scand J Urol, 2016, 50(3): 216-219．
[19]	张欢，张俊，南小新, 等. 微创经皮肾镜碎石取石术治疗成人多囊肾合并肾结石20例分析[J]. 重庆医学, 2014, 3(1): 98-99
[20]	江哲龙，潘凡，吕立志, 等. 冷激光联合胆道镜治疗胆道术后残余结石效果分析[J]. 临床肝胆病杂志, 2016, 32(11): 2138-2140.
[21]	Bader MJ, Gratzke C, Heeht V, et a1. Impact of collateral damage to endourologic tools during laser lithotripsy-in vitro comparison of three different clinical laser systems[J]. J Endourol, 2011, 25(4): 667-672.
[22]	Liu F, Jin ZD, Zou DW, et al. Efficacy and safety of endoscopic biliary lithotripsy using FREDDY laser with a radiopaque mark under fluoroscopic guidance[J].Endoscopy, 2011, 43(10): 918-921.
[23]	施剑灵，鲁军. 经皮肾镜取石术后发热的影响因素及其预防[J]. 中华泌尿外科杂志, 2010, 31(8): 571-573．
[24]	罗小敏，张茨，钱辉军, 等. 输尿管镜钬激光治疗肾盏结石术中出现液体外渗的因素分析[J]. 中华泌尿外科杂志, 2010, 31(8): 512-515．
[25]	Probhakar M.Retorgrade ureteroscopic intrarenal surgery for large(1.6-3.5 cm) upper ureteric/renal calculus[J]. Indian J Urol, 2010, 126(1): 46-49.

组别	例数	性别（例）		年龄（岁，±s）	结石部位（例）
组别	例数	男	女	年龄（岁，±s）	肾盂	上盏	中盏	下盏
观察组	98	76	22	37±12	26	32	22	18
对照组	94	75	19	40±11	25	30	21	18
统计值	?	χ²=0.143		t=2.34	χ²=0.019
P值	?	>0.05		>0.05	>0.05

组别	例数	性别（例）		年龄（岁，±s）	结石部位（例）
组别	例数	男	女	年龄（岁，±s）	肾盂	上盏	中盏	下盏
观察组	98	76	22	37±12	26	32	22	18
对照组	94	75	19	40±11	25	30	21	18
统计值	?	χ²=0.143		t=2.34	χ²=0.019
P值	?	>0.05		>0.05	>0.05

组别	例数	手术时间(min)	术中出血量(ml)	住院天数(d)
观察组	98	83±13	47±13	3.4±0.5
对照组	94	116±17	83±11	3.5±0.5
t值	?	15.46	20.89	0.98
P值	?	<0.05	<0.05	>0.05

组别	例数	手术时间(min)	术中出血量(ml)	住院天数(d)
观察组	98	83±13	47±13	3.4±0.5
对照组	94	116±17	83±11	3.5±0.5
t值	?	15.46	20.89	0.98
P值	?	<0.05	<0.05	>0.05

组别	例数	术后出血	感染	输尿管穿孔	急性肾功能不全	结石清除率
观察组	98	3	6	1	2	89(91%)
对照组	94	10	15	3	1	73(78%)
χ²值	?	4.364	4.76	1.11	1.34	6.30
P值	?	<0.05	<0.05	>0.05	>0.05	<0.05

Please choose a citation manager

Content to export