后腹腔镜治疗泌尿外科疾病的效果观察

目的比较后腹腔镜与传统开放手术在泌尿外科疾病治疗中的临床效果，从而评价后腹腔镜在临床中的应用价值，为今后诊疗提供依据。方法选择2009年2月～2011年12月治疗的患者184例，包括43例肾脏切除术、47例肾上腺手术、37例行肾囊肿去顶减压术和57例输尿管切开取石患者，随机分为后腹腔镜组和开放式手术组，每组各92例。后腹腔镜组患者行后腹腔镜手术治疗，开放式手术组患者，行常规开放手术。比较两组患者的手术时间、术中出血量、术中输血例数、患者下床活动时间、拔除引流管时间、住院时间以及术后并发症发生率。结果术后后腹腔镜组患者与开放式手术组比较，手术时间较短，术中出血量少，术中输血例数较少，患者下床活动时间早，拔除引流管时间较早，住院时间较短，各项指标差异均有统计学意义（P〈0．05或P〈0．01）。两组患者均无死亡病例；术后后腹腔镜组并发症发生率（0）低于开放式手术组（5．43％），差异有高度统计学意义（χ2=6．982，P〈0．01）。结论后腹腔镜较传统手术在泌尿外科运用时具有安全、术后恢复快、并发症少等优势。

Observation on the clinical effect of retroperitoneal laparoscopy in treatment of urological diseases

Objective To compare the clinical effect of retroperitoneal laparoscopy and traditional open surgery in treatment of urological diseases, and to provide treatment reference for further application of retroperitoneal la- paroscopy. Methods A total of 184 patients including 43 patients with nephrectomies, 47 patients with adrena surgery, 37 patients with renal cyst decortications and 57 patients with ureterolithotomy from February 2009 to December 2011 were selected randomly and divided into retroperitoneal laparoscopy group and traditional open surgery group with 92 cases in each group. The surgery time, amount of bleeding during surgery, number of blood transfusion during surgery, time of activity, time of drain removal and time of hospitalization as well as complications were compared. Results The surgery time in retroperitoneal laparoscopy group was shorter than that in traditional open surgery group, amount of bleeding during surgery in retroperitoneal laparoscopy group was smaller than that in traditional open surgery group, the number of blood transfusion during surgery in retroperitoneal laparoscopy group was fewer than that in traditional open surgery group, the time of activity in retroperitoneal laparoscopy group was shorter than that in traditional open surgery group, the time of drain removal in retroperitoneal laparoscopy group was shorter than that in traditional open surgery group, the time of hospitalization in retroperitoneal laparoscopy group was shorter than that in traditional open surgery group, the differences were all statistically significant （P 〈 0.05 or P 〈 0.01）. No death case was found, com- plication rate in traditional open surgery group （5.43%） was higher than that in retroperitoneal laparoscopy group （0）, the differences was statistically significant （χ2= 6.982, P 〈 0.01）. Conclusion The retroperitoneal laparoscopy has the aspects of safety, faster recovery after surgery and fewer complications.