腹腔镜和输尿管镜治疗脓肾合并输尿管上段结石的对照分析

目的 探讨比较腹腔镜输尿管切开取石术与输尿管镜钬激光碎石术治疗脓肾合并输尿管上段结石的疗效.方法 分别对筛选患者采用输尿管镜钬激光碎石术21例,腹腔镜下输尿管切开取石术20例;采集有无术中结石滑脱及术后感染性休克等资料,定期随访尿常规、泌尿系彩超、患肾功能、输尿管狭窄等.结果 41例患者均康复满意;腹腔镜组手术及住院时间稍长于输尿管镜组(P＜0.05);腹腔镜组结石滑脱及感染性休克发生率明显低于输尿管镜组,差异有统计学意义(P＜0.05);术后随访示,尿白细胞、肾皮质厚度、患肾功能较术前均明显改善(P＜0.05),两组之间差异无统计学意义(P＞0.05).结论 腹腔镜输尿管切开取石术是相对安全有效地治疗脓肾合并输尿管上段结石的方法,是对输尿管镜技术的有效补充和支持.

The contrast between laparoscopy and ureteroscopy in the treatment of calculous pyonephrosis

Objectives To investigate laparoscopic ureterolithotomy and ureteroscopic holmium laser lithotripsy in the treatment of calculous pyonephrosis.Methods 41 cases were divided into ureteroscopy group(21 cases) and laparoscopy group (20 cases).Incidences of stone slip and spetic shock were compared in the two groups.The follow up data were collected to investigate the changes of routine urine,the results of ultrasound and renal function of pyonephrosis.Results The operations were successful in all 41 cases.Incidences of stone slip and spetic shock in laparoscopy group was significantly lower than ureteroscopy group (P ＜ 0.05).According to the follow-up data,routine urine,the results of ultrasound and renal function of pyonephrosis was significantly improved (P ＜ 0.05).Conclusions It is effect and safe to use laparoscopic ureterolithotomy in the treatment of calculous pyonephrosis is a safe and effective method,and laparoscopy is the useful complement and support for ureteroscopy.