腹腔镜肾盂成形术联合输尿管软镜取石术治疗肾盂输尿管连接部梗阻合并肾脏结石临床研究

目的 观察腹腔镜肾盂成形术联合输尿管软镜取石术治疗肾盂输尿管连接部梗阻合并肾脏结石效果,并探讨其安全性.方法 选择本院于2013年1月至2014年12月收治的肾盂输尿管连接部梗阻合并肾脏结石患者72例作为研究对象,均符合手术指征,按照数字随机法分为两组,每组36例,对照组采取开放手术治疗,观察组采取腹腔镜肾盂成形术联合输尿管软镜取石术治疗,比较两组疗效.结果 观察组手术时间及术中出血量分别为(125.9 ±29.6)min、(124.7 ±45.2) mL,均显著低于对照组(187.9±35.6) min、(298.6 ±63.8)mL,差异具有统计学意义(P＜0.05).观察组住院时间、引流管拔除时间及术后胃肠道恢复时间均低于对照组,差异具有统计学意义(P＜0.05).观察组术后的并发症为7例(19.4％),与对照组8例(22.2％),差异无统计学意义(P＜0.05).结论 腹腔镜肾盂成形术联合输尿管软镜取石术治疗肾盂输尿管连接部梗阻合并肾脏结石效果较佳,创伤小,术后恢复快,具有重要临床价值.

The clinical study of laparoscopic pyeloplasty combined with flexible ureteroscope in the treatment of ureteropelvic junction obstruction and renal calculi

Objectives To observe the efficacy and safety of laparoscopic pyeloplasty combined with flexible ureteroscope in the treatment of ureteropelvic junction obstruction and renal calculi.Methods 72 cases patients with ureteropelvic junction obstruction and renal calculi were treated in our hospital from January 2013 to December 2014 as the research object,and all patients were randomly divided into two groups with 36 cases in each group.The patients of the control group were treated with open surgery,and patients of the observation group underwent laparoscopic pyeloplasty combined with flexible ureteroscopy.The therapeutic effects were compared in the two groups.Results The observation group'operation time and amount of bleeding was (125.9 + 29.6) min,(124.7 + 45.2) mL respectively,and were significantly less with observation group than that with control group (187.9 + 35.6) min,(298.6 + 63.8) mL(P ＜ 0.05).The time of hospitalization,drainage tube extraction and recovery time of gastrointestinal tract in the observation group were less than those in the control group,and the differences were statistically significant (P ＜ 0.05).The postoperative complications of the observation group were 7 cases(19.4％),while there were 8 cases (22.2％) in the control group,the difference was not statistically significant (P ＜ 0.05).Conclusions Laparoscopic pyeloplasty combined with flexible ureteroscopy in the treatment of ureteropelvic junction obstruction and renal calculi has good effect,less trauma and rapid postoperative recovery,which is an important clinical value.