经皮肾镜与经尿道输尿管镜治疗输尿管上段嵌顿性结石的疗效比较

目的探讨经皮肾镜取石术（PCNL）与经尿道输尿管镜碎石术（uRL）两种手术方式在输尿管上段嵌顿性结石治疗中的疗效差异。方法将120例输尿管上段嵌顿性结石患者随机分为经皮肾镜组（PCNL组）和经尿道输尿管镜组（URL组），两组各60例，分别对术后各项情况进行比较分析。结果PCNL组患者的手术时间、肉眼血尿时间及术后住院天数均长于URL组，但术后3d结石清除率及术后30d结石清除率明显高于经URL组，各项比较均有显著性差异（P〈0．05）。结论PCNL治疗输尿管上段嵌顿性结石较URL有明显的优势，虽创伤较URL大，但其结石清除率高，仍应成为输尿管上段嵌顿性结石的首选术式。

Comparative Effectiveness Research ofPercutaneous Nephrolithotomy and Transurethral Ureteroscopy Lithotripsy on the Incaecerated Upper Ureteral Calculi

Objective To compare the clinical effect of percutaneous nephrolithotomy and transurethral ureteroscopy lithotripsy on the incaecerated upper ureteral calculi. Methods 120 patients with incaecerated upper ureteral calculi were divided randomly into percutaneous nephrolithotomy group（PCNL group） （60 cases）and transurethral ureteroscopy lithotripsy group（URL group） （60 cases）,and to analyse the postoperative situation of two groups. Results The outcome of operating time, gross hematuria time and hospital stay of PCNL group were significantly longer than that of URL group,but the stone free rate of PCNL group was significantly superior to that of URL group at 3d and 30d after surgery（all P〈0.05）. Conclusion The clinical effect of PCNL is superior to that of URL on the incaecerated upper ureteral calculi, PCNL has high stone free rate though its damage is higer than URL for the moment,it is ought to considered as the first choice of the incaecerated upper ureteral calculi.