MPCNL与URL治疗输尿管上段嵌顿性结石的临床疗效比较分析

目的探讨微创经皮肾穿刺碎石术(MPCNL)及输尿管镜碎石术(URL)治疗输尿管上段嵌顿性结石的临床疗效。方法回顾性分析2010年4月～2012年1月在我院因输尿管上段嵌顿性结石住院治疗的患者98例,其中39例接受微创经皮肾穿刺碎石术治疗,59例接受输尿管镜碎石术治疗,统计分析两种手术方法的临床疗效。结果 MPCNL组及URL组手术时间分别为(121.68±15.73)min、(68.35±9.17)min(P<0.05);MPCN组术后3天及1个月后结石清除率分别为94.8%(37/39)、100%(39/39),URL组术后3天及1个月后结石清除率分别为57.63%(34/59)、81.36%(48/59),MPCNL组较URL组结石清除率显著增高(P<0.05);术后MPCNL组及URL组平均住院天数分别为(10±2.3)d及(5±1.2)d(P<0.05)。结论 URL在手术时间及术后住院天数上优于MPCNL,而在结石清除率方面MPCNL明显优于URL。

Comparison of clinical efficacy of MPCNL and URL in impacted upper ureteral calculi

Objective To investigate the clinical effect of the minimally invasive percutaneous nephrolithotomy(MPCNL) comparing with transurethral ureteroscope lithotripsy(URL) in treating impacted upper ureteral calculi.Methods Ninety-eight cases of impacted upper ureteral calculi treated in our hospita1 from April 2010 to January 2012,including thirty-nine cases of MPCNL and fifty-nine cases of URL.Compared the clinical efficacy of the two kinds of surgical method.Results The operation time of MPCNL was(121.68±15.73) minutes,URL was(68.35±9.17)minutes.After MPCNL,the postoperation stone-free rate was 94.8%(37/39) in 3 days,and it was 100%(39/39) in a month.After URL the postoperation stone-free rate in 3 days and in a month were 57.63%(34/59) and 81.36%(48/59) respectively.Compared with URL group,MPCNL group in 3 days and 1 month postoperation got a higher stone-free rate(P<0.05).The average postoperation hospital stay of MPCNL was(10±2.3)days and URL was(5±1.2)days(P<0.05).Conclusions The operation time and the average postoperative hospital stay of URL are shorter than MPCNL,but the stone-free rate of MPCNL is higher than URL.