嵌顿性输尿管上段结石不同治疗方法对比研究

目的比较三种不同微创手术方法治疗嵌顿性输尿管上段结石的疗效。方法对广西中医学院第一附属医院120例嵌顿性输尿管上段结石患者的临床资料进行回顾性分析,其中后腹腔镜输尿管切开取石术(RPUL)组36例,输尿管镜下取石术(URL)34例,微创经皮肾镜取石术(MPCNL)50例。比较3组手术时间、术后出血量、结石清除率及并发症发生率。结果 RPUL组、URL组及MPCNL组结石清除率分别为91.7%、70.6%和96.0%,RPUL组及MPCNL组显著优于URL组(P<0.05);RPUL组、URL组及MPCNL组手术时间分别为(129.46±23.08)、(37.58±5.83)及(80.32±9.47)min,差别具有统计学意义(P<0.05);3组术后出血量分别为(30.31±4.28)、(26.36±3.71)及(82.36±6.21)ml,RPUL组及URL组显著少于MPCNL组(P<0.05);3组并发症发生率分别为8.3%、5.9%和8.0%,差别无统计学意义(P>0.05)。结论与URL相比,MPCNL及RPUL治疗嵌顿性输尿管上段结石清石率高,且安全有效。

Comparative analysis of therapeutic effects from three minimally invasive surgery methods on impacted upper ureteral calculus

Objective To compare the effects of three minimally invasive surgery methods on impacted upper ureteral calculus.Methods The data of 120 cases of impacted upper ureteral calculus were retrospectively analyzed.120 patients were divided into retroperitoneoscopic ureterolithotomy(RPUL) group(n=36),ureteroscopic lithotripsy(URL) group(n=34) and minimally invasive percutaneous nephrolithotripsy(MPCNL) group(n=50).Operation time,postoperative blood loss,the calculus elimination rate and complication rate were compared between three groups.Results The calculus elimination rates of three groups were 91.7%,70.6% and 96.0% respectively,significantly lower in group URL than in group RPUL and group MPCNL(P<0.05);Operation time were(129.46±23.08),(37.58±5.83) and(80.32±9.47) min with significant difference(P<0.05);Postoperative blood loss of group RPUL and group URL were much less that of group MPCNL[(30.31±4.28) vs(26.36±3.71) vs(82.36±6.21)ml,P<0.05];The complication rates were 8.3%,5.9% and 8.0% in three groups without significant difference(P>0.05).Conclusions Compared with URL,MPCNL and RPUL for impacted upper ureteral calculus have high calculus elimination rates and safe effect.