微创经皮肾镜与后腹腔镜手术治疗输尿管上段结石的疗效比较

目的比较微创经皮肾镜（m PCNL）与后腹腔镜（RLU）手术治疗输尿管上段结石的临床疗效。方法回顾性分析69例输尿管上段结石患者的临床资料。其中采用m PCNL治疗33例（A组）,采用RLU治疗36例（B组）,比较两组的手术时间、住院时间、手术成功率、结石清除率及并发症发生率。结果 A组手术时间明显短于B组（38.8±5.2）min vs（60.5±8.5）min,P〈0.05],差异有统计学意义。两组的术后住院时间、手术成功率、结石清除率及手术并发症发生率分别为（6.6±1.1）d vs（6.2±1.3）d、96.96%vs 94.44%、100%vs 100%、6.25%vs5.88%,差异均无统计学意义（P〉0.05）。两组均未出现大出血病例。结论 m PCNL和RLU均是治疗输尿管上段结石安全可靠、疗效肯定的手术方式,应根据具体情况及患者意愿制定出个体化治疗方案,以达降低损伤、减少并发症、提高清石率的治疗目的。

Comparative study on the clinical efficacy of mPCNL and RLU for the treatment of upper ureteral calculi

Objective To compare the clinical efficacy of minimally invasive treatment of upper ureteral calculus by minimally invasive pereutanenus nephrolithotripsy （mPCNL） and retroperitoneal laparoseopic ureterolithotomy （RLU）. Methods The clinical data of 69 cases of upper ureteral calculi was retrospectively analyzed. Group A （33 patients） received mPCNL, and group B （36 patients） was treated by RLU. Results The operation time was sig- nificantly shorter in group A than group B （38.8±5.2） rain vs （60.5±8.5） min,P〈0.05]. There was no statistically significant different in postoperative hospital stay （6.63：1.1） d vs （6.2±1.3） d]., the successful rate of operation （96.96% vs 94.44%）, stone-free rate （100% vs 100%）, operation related complications rate （6.25% vs 5.88%） between two groups, all with P〉0.05. Contusion The mPCNL and RLU are both effective and safe methods for ureteral calculi. In order to reduce the damages and complications, improve the stone-free rate, we should choose different procedures according to the actual situation.