经皮肾镜与输尿管镜治疗输尿管中上段结石疗效对比分析(附216例报告)

目的 采用经皮肾镜取石术(PCNL)与输尿管镜碎石术(URL) 治疗输尿管中上段结石,并比较其疗效.方法 从2008年5月至2011年12月,216例单侧输尿管中上段结石,PCNL组126例,URL组90例,URL组在术中配合使用结石套篮,部分病例术后配合ESWL.结果 PCNL组手术成功率为100%(126/126),一次结石清除率为97%(122/126).URL组手术成功率为72%(65/90),一次结石清除率57%(51/90),术后1个月时结石清除率为87%(78/90),均显著低于PCNL组(P<0.05).结论 PCNL治疗输尿管中上段结石效果肯定,手术成功率和结石清除率较高;URL疗效稍差,但配合使用套石篮等辅助设备,术后联合ESWL均可显著提高疗效,出血及感染发生率明显低于PCNL组,临床可根据患者情况选择.

The efficacy analysis of percutaneous nephrolithotomy and ureteroscopic treatment of middle and upper ureteral stones compared(216 cases report)

Objective Purpose for middle and upper ureteral calculi,percutaneous nephrolithotomy surgery(PCNL)and ureteroscopic lithotripsy(URL),and compare its efficacy,Methods From May 2008 to December 2011,216 patients with unilateral ureteral stone patients,126 were treated with PCNL treatment,90 patients with URL therapy,intraoperative use of stones set basket,in some cases the use of ESWL Postoperative adjuvant therapy.Results PCNL group surgical success rate was 100%(126/126),a stone clearance rate was 97%(122/126).URL operative success rate was 72%(65/90),a stone clearance rate of 57%(51/90),in some cases after adjuvant ESWL,stone clearance rate was 87%(78/90)after a month,were significantly lower than PCNL group(P<0.05),Conclusion Percutaneo-us nephrolithotomy lithotripsy for middle and upper ureteral stones,the exact clinical effects,success rates and stone clearance rates were higher.Contrast,ureteroscopic lithotripsy less effective,but the intraoperative use of sets of stone basket and other auxiliary equipmen,doctor’s own clinical experience,and postoperative joint could significantly improve the efficacy of ESWL,and the risk of bleeding and infection are relatively low,can be selected according to the patient’s condition.