URL和PCNL治疗输尿管上段结石272例临床分析

目的 比较经输尿管镜下碎石术(ureteroscopic lithotomy,URL)与经皮肾镜取石术(percutaneous nephrolithotomy,PCNL)两种术式治疗输尿管上段结石后不同时间段的结石取净率,探讨两者利弊,为临床决策提供依据.方法 回顾性分析2008年6月30日至2011年6月30日收治的输尿管上段结石患者272例的病历资料,其中179例采用URL治疗,93例采用PCNL治疗.结果 URL组和PCNL组术后3d、1周后、1个月后结石清除率分别为(81.4％ vs 95.7％,P＜0.01)、(90.5％ vs 97.8％,P＜0.05)、(94.7％ vs 100％,P＞0.05).结论 PNCL组结石取净率优于URL组,但远期差异不确定.

Clinical analysis of URL and PCNL for treating 272 cases of upper ureteral calculi

Objective To compare the stones clearance rates in different periods between ureteroscopic lithotomy(URL) and percutaneous nephrolithotomy(PCNL) for treating upper ureteral calculi and to investigate their advantages and disadvantages to provide basis for the clinical strategic decision.Methods The clinical data in 272 cases with upper ureteral calculi treated from June 30,2008 to June 30,2011 were retrospectively analyzed.Among them,189 cases underwent URL and the other 93 cases adopted PNCL.Results The stones clearance rates of 3 d,a week and a month later in URL and PCNL were 81.4% vs.95.7%(P<0.01),90.5% vs.97.8%(P<0.05) and 94.7% vs.100%(P>0.05),respectively.Conclusion The stone clearance rate of PCNL is higher than that of URL,but the long-term difference is uncertain.