经皮肾取石和输尿管镜碎石治疗嵌顿性输尿管上段结石的疗效比较

目的比较经皮肾取石和输尿管镜碎石治疗嵌顿性输尿管上段结石的疗效。方法回顾性地分析66例嵌顿性输尿管上段结石患者的临床资料，经皮肾取石31例，输尿管镜碎石35例。分别对其结石清除率、手术时间、住院时间、并发症发生率、术后辅助治疗、住院费用等数据进行对比分析。结果经皮肾取石术后结石清除率为93．5％（29／31），平均血红蛋白下降约3．89％，并发症发生率为6．5％（2／31），平均住院时间为8.3天，平均住院费用为8976元。输尿管镜碎石术后一个月结石清除率为77．1％（27／35），平均血红蛋白下降约0．29％，并发症发生率为8．6％（3／35），平均住院时间为7．6天，平均住院费用为8631元。结论经皮。肾取石较输尿管镜碎石治疗嵌顿性输尿管上段结石结石清除率高，并发症少，安全有效，可作为嵌顿性输尿管上段结石的一线治疗方法。

A comparative study of percutaneous nephrolithotomy and ureteroscopic lithotripsy for the treatment of impacted upper ureteral stones

objective To compare the effect of percutaneous ncphrolithotomy （PCNL） with uretcroscopic lithotripsy （URL） for the treatment of impacted upper ureteral stones. Methoda 31 patients underwent percutaneous nephrolithotomy, the other 35 patients underwent ureteroscopic lithotripsy. The rate of stone clearance, the time of operation, the day of hospitalization, recurrence, postoperative adjuvant therapy and the cost of hospitalization were collected. The clinical data of 66 patients with upper ureteral stones were compared retrospectively. Results The stone-free rate at 1 month follow-up was 93.5%（29/31） in percutaneous nephrolithotomy group and 77.1%（27/35） in ureteroscopic lithotripsy group. The mean degree of haematoglobin in PCNL and URSL groups decreased 3.89% and 0.29% respectively. The rates of complications in PCNL and URSL groups were 6.5%（2/31） and 8.6%（3/35）. The mean hospital stay was 8.3 days and 7.6 days. The mean hospital cost was 8976 yuan and 8631 yuan. Conclusions For an impacted, upper ureteral stones, PCNL had a better stone-free rate and few complications which could be the first choice.