| Objective: To retrospectively analyze the influence of CT value of renal calculi on the lithotripsy rate,efficacy and safety in the treatment of calculi with transurethral ureteroscope(FURL)and percutaneous nephroscope(PCNL),so as to provide a certain reference basis for clinicians to estimate the operation duration and evaluate the lithotripsy efficacy before operation.Methods: The medical records of patients who underwent flexible ureteroscopic lithotripsy or percutaneous nephrolithotripsy in our hospital since 2021 were collected and collated.A total of 155 patients were included after screening according to established criteria,including 100 patients who underwent flexible ureteroscopic holmium laser lithotripsy and 55 patients who underwent standard channel percutaneous nephrolithotripsy.All patients underwent CT examination in our hospital before operation,and the stone size and CT value were measured and recorded.After all patients were divided into group A(soft mirror group)and group B(nephroscope group)according to the surgical method,the patients with average CT value greater than or equal to 1000 Hu in group A and group B were divided into groups A1 and B1 respectively,and the patients with average CT value less than 1000 Hu in group A and group B were divided into groups A2 and B2 respectively.All patients were standardized to control infection before operation,and preoperative examination was improved to eliminate contraindications.During the operation,all stones should be removed at one time as much as possible,and larger stones should be removed as much as possible.Compare the operation duration,lithotripsy rate,stone-clearing rate and other indicators between the groups to determine whether there is any difference in the operation effectiveness;By comparing the length of hospital stay,the amount of bleeding,and the presence of fever or other surgical complications in each group,we can determine whether there are differences in surgical safety.Results: In this study,there were 100 patients in group A and 55 patients in group B.There was no significant difference in age,sex,stone location,maximum diameter of stone and estimation of stone volume between A1,A2 and B1,B2 groups(P>0.05).The length of operation,postoperative hospital stay,residual stone rate,Hb difference before and after operation,and the proportion of patients with fever in group A1 were all higher than those in group A2,while the rate of lithotripsy in group A1 was lower than that in group A2,and the difference was statistically significant(P<0.05).The operation time of group B1 was longer than that of group B2,and the lithotripsy rate was lower than that of group B2,and the difference was statistically significant(P<0.05);However,there was no significant difference between the two groups in terms of average postoperative hospitalization time,residual stone rate,proportion of patients with fever and bleeding volume(P>0.05).Conclusion: 1.When the CT value of stones is greater than 1000 Hu,the lithotripsy rate of FUL and PCNL decreases;2.When the CT value of calculus is greater than 1000 Hu,the length of hospital stay,the amount of bleeding and the proportion of patients with fever after FUL operation increased,and the curative effect of lithotripsy decreased significantly,but there was no significant impact on PCNL. |
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