微创经皮肾镜取石术和经输尿管镜取石术治疗输尿管上段嵌顿性结石的疗效比较

目的:比较微创经皮肾镜取石术(minimally invasive percutaneous nephrolithotomy,MPCNL)和经输尿管镜取石术(trans-ureteroscope lithotripsy,URL)治疗输尿管上段嵌顿性结石的疗效。方法:将130例输尿管上段嵌顿性结石患者按照手术方式不同分为微创经皮肾镜取石组(MPCNL组)和经输尿管镜取石术组(URL组),每组各65例。观察两组术后3～5d和术后1个月的结石清除率和并发症发生情况。结果:MPCNL组术后3～5d和术后1个月的结石清除率分别为92.31%和96.92%,URL组术后3～5d和术后1个月的结石清除率分别为64.62%和84.62%,MPCNL组术后结石清除率显著高于URL组(P<0.05)。MPCNL组术后并发症发生率为24.67%,URL组术后并发症发生率为10.77%,2组无显著差异(P>0.05)。结论:MPCNL治疗输尿管上段嵌顿性结石的疗效优于URL,对于较大的输尿管上段嵌顿性结石MPCNL可作为首选的治疗方法。

Comparison of Minimally Invasive Percutaneous Nephrolithotomy and Trans-Ureteroscope Lithotripsy in theTreatment of Upper Ureterai Incarcerated Stones

Objective：To investigate the efficacy of minimally invasive percutaneous nephrolithotomy（MPCNL）and trans-uret eroscope lithotripsy（URL） in upper ureteral incarcerated stones. Methods： A total of 130 patients with upper ureteral incarcer- ated stones were divided into URL group and MPCNL group（n = 65）. The stone clearance rates were observed 3-5 day and 1 month after operation. Hemoglobin （Hb） was detected preoperatively and 3 day after operation, The complications were al3o observed. Results： The stone clearance rates of MPCNL group of postoperative 3-5 day and 1 month were 92. 31% and 96.92%, respectively： and those of URL group were 64. 62% and 84. 62%, respectively. The rates of stone clearance in MPC- NL group were significantly higher than those in URL group （P〈0.05）. The incidence of complications was 24.67% in MPC- NL group, and 10.77% in URL group. There was no significant difference in the incidence of complications between the two groups （P〉0.05）. Conclusions.. The efficacy of MPCNL was significantly better than that of URL in the treatment of upper u- reteral incarcerated stones. MPCNL can be the first choice for large ureteral segments incarcerated stones.