后腹腔镜下输尿管切开取石术治疗复杂性上输尿管结石的效果观察

目的观察后腹腔镜下输尿管切开取石术治疗复杂性上输尿管结石的效果。方法纳入我院62例复杂性上输尿管结石患者进行回顾性分析,根据治疗方式不同分为对照组(实施输尿管软镜钬激光碎石术)31例、实验组(实施后腹腔镜下输尿管切开取石术)31例。记录两组患者手术情况(手术耗时、住院时间、术后双J管留置时间),术前、术后1个月患侧肾小管滤过率(GFR)变化以及术后结石清除率、发热率。结果两组患者手术耗时无显著差异(P>0.05),实验组住院时间长于对照组(P<0.05),术后双J管留置时间短于对照组(P<0.05);两组患者术后1个月复查患肾GRF均无显著变化,两组对比差异无统计学意义(P>0.05);实验组患者结石清除率高于对照组,发热率低于对照组,差异均有统计学意义(P均<0.05)。结论后腹腔镜下输尿管切开取石术治疗复杂性上输尿管结石疗效显著且安全性高,结石清除率高理想。

Effects of Retroperitoneal Laparoscopic Ureterolithotomy in the Treatment of Complex Upper Ureteral Calculi

Objective To observe the effects of retroperitoneal laparoscopic ureterolithotomy in the treatment of complicated upper ureteral calculi.Methods A retrospective analysis was performed on 62 patients with complicated upper ureteral calculi in our hospital.According to different treatment methods,the patients were divided into control group(given ureteroscope holmium laser lithotripsy,31 cases)and experimental group(given retroperitoneal laparoscopic ureterolithotomy,31 cases).The operation status(operative time,hospital stay,postoperative double J tube indwelling time),glomerular filtration rate(GFR)of affected side before operation and at 1 months after operation and postoperative stone removal rate and fever rate were recorded in the two groups.Results There was no significant difference in the operative time between the two groups(P>0.05),and the hospital stay in experimental group was longer than that in control group(P<0.05),and the indwelling time of postoperative double J tube was shorter than that in control group(P<0.05).There was no significant change in the GRF of affects kidneys at review at 1 month after operation in the two groups,and there was no significant difference between the two groups(P>0.05).The stone removal rate in experimental group was higher than that in control group,and the fever rate was lower than that in control group(P<0.05).Conclusion Retroperitoneal laparoscopic ureterolithotomy has significant efficacy and high safety in the treatment of complicated upper ureteral calculi,and it has high and ideal stone removal rate.