输尿管镜与微创经皮肾镜治疗输尿管上段结石的临床疗效比较

目的比较输尿管镜取石术及微创经皮肾镜取石术(MPCNL)治疗输尿管上段结石的临床疗效及风险.方法共141例患者,输尿管镜取石术72例,MPCNL69例.对手术成功率、一期结石清除率、并发症发生率、平均住院时间及平均住院费用等进行比较分析.结果输尿管镜取石组手术成功率99%,MPCNL组100%;输尿管镜检取石组一期结石清除率61%,MPCNL组77%,差异有统计学意义(P<0.05);输尿管镜取石组手术并发症发生率7%,MPCNL组16%,差异无统计学意义(P>0.05);输尿管镜取石组平均住院时间(7±4.0)d,MPCNL组(11±3.0)d,差异有统计学意义(P<0.05);输尿管镜取石组平均住院费用(6 558±860)元,MPCNL组(11 230±2 045)元,差异有统计学意义(P<0.05).结论输尿管镜取石术处理输尿管上段结石的一期结石清除率低于经皮肾镜取石术,但具有更高的安全性、更短的住院时间及更少的住院费用,有利于患者,值得采用.

Clinical Results of Minimally Invasive Percutaneous Nephrolithotomy and Transurethral Ureteroscopic Lithotripsy on Treatment of Upper Ureteric Calculi

Objective To observe the clinical results and risks of minimally invasive percutaneous nephrolithotomy and transurethral ureteroscopic lithotripsy on treatment of upper ureteric calculi.Methods 141 patients with upper ureteric calculi accepted minimal invasive treatment in our department,72 of them accepted the therapy of transurethral ureteroscopic lithotripsy,and 69 accepted minimally invasive percutaneous nephrolithotomy(MPCNL),and the success rate,clearance rate of stone in first time of operation,rate of complications,hospitalization time and hospitalization expenses were compared between these 2 groups.Results The success rate of transurethral ureteroscopic lithotripsy group was 99%,and that of MPCNL group was 100%.The clearance rate in first time of operation of transurethral ureteroscopic lithotripsy group was 61%,and that of MPCNL group was 77%,and the difference is significant(P<0.05).The rate of complications of transurethral ureteroscopic lithotripsy group was 7%,and that of MPCNL group was 16%,the difference is insignificant(P>0.05).The average hospitalization time of transurethral ureteroscopic lithotripsy group was 7±4.0 days,and that of MPCNL group was 11±3.0days,the difference is significant(P<0.01).The average hospitalization expenses of transurethral ureteroscopic lithotripsy group was 6558±860 Chinese dollar,and that of MPCNL group was 11230±2045 Chinese dollar,the difference is significant(P<0.01).Conclusion When compared with MPCNL,transurethral ureteroscopic lithotripsy can get a lower rate of success and clearance of stone,however,this operation deserves performing at first for its advantage in safety,hospitalization time and hospitalization expenses.