经皮肾镜与输尿管镜治疗嵌顿性输尿管上段结石的疗效

目的 探究经皮肾镜与输尿管镜在治疗嵌顿性输尿管上段结石中的疗效。方法 回顾性分析2017年1月~2018年12月在我院收治的100例嵌顿性输尿管上段结石患者临床资料，依据手术治疗方式将其分为研究组（58例）和对照组（42例），研究组采取经皮肾镜手术治疗，对照组采取输尿管镜碎石治疗。比较两组手术时间、术中出血量、住院时间、结石清除率及并发症发生情况。结果 研究组手术时间（54.3±9.23）min、术中出血量（238.21±32.63）ml、住院时间（8.75±3.16）d均高于对照组的（51.4±7.64）min、（184.37±96.22）ml、（5.92±2.43）d，差异具有统计学意义（P＜0.05）。研究组术后高热6例，对照组5例（P＞0.05）；研究组术后1月结石清除率（98.28%）高于对照组（85.71%），差异具有统计学意义（P＜0.05）；两组均未出现输尿管损伤、穿孔。结论 尽管经皮肾镜治疗嵌顿性输尿管上段结石患者相对出血量稍多、住院时间较长，但结石清除率高，且并发症少、操作简单、安全性高，是治疗嵌顿性输尿管上段结石的有效方法之一。

Percutaneous Nephrolithotomy and Ureteroscopy for the Treatment of Incarcerated Ureteral Calculi

Objective To investigate the efficacy of percutaneous nephrolithotomy and ureteroscopy in the treatment of incarcerated ureteral calculi. Methods The clinical data of 100 patients with incarcerated ureteral calculi admitted to our hospital from January 2017 to December 2018 were retrospectively analyzed. According to the surgical treatment, they were divided into study group (58 cases) and control group (42 cases). The study group was treated with percutaneous nephrolithotomy and the control group was treated with ureteroscopic lithotripsy. The operation time, intraoperative blood loss, hospitalization time, stone clearance rate and complications were compared between the two groups.Results The operation time of the study group (54.3±9.23) min, intraoperative blood loss (238.21±32.63) ml, and hospitalization time (8.75±3.16) d were higher than those of the control group (51.4±7.64) min, (184.37±96.22) ml, (5.92±2.43)d, the difference was statistically significant (P<0.05). The study group had high fever after operation in 6 cases and control group in 5 cases (P>0.05). The stone clearing rate (98.28%) in the study group was higher than that in the control group (85.71%),the difference was statistically significant(P<0.05). There was no ureteral injury or perforation in either group.Conclusion Although percutaneous nephrolithotomy for patients with incarcerated upper ureteral calculi has a relatively large amount of hemorrhage and a longer hospital stay, however, the high stone removal rate, less complications, simple operation and high safety is one of the effective methods for the treatment of incarcerated ureteral calculi.