微创经皮肾穿刺取石术与经尿道输尿管镜碎石术对输尿管上段结石的疗效对比

目的对比观察微创经皮肾穿刺取石术(MPCNL)与经尿道输尿管镜碎石术(URL)治疗输尿管上段结石的疗效。方法 85例嵌顿性输尿管上段结石患者随机分成观察组和对照组,分别采用MPCNL治疗和URL治疗,统计并比较两组的住院时间、手术时间、术中出血量、结石清除率及并发症发生情况。结果观察组手术时间、术中出血量、住院时间分别为(64.3±15.6)min、(123.5±38.2)ml、(13.2±2.1)d,均显著高于对照组,组间比较差异有统计学意义(P﹤0.05);观察组术后3 d和术后1月结石清除率分别为93.0%和97.7%,均显著高于对照组,组间比较差异有统计学意义(P﹤0.05);两组并发症发生率比较差异无统计学意义(P﹥0.05)。结论 MPCNL治疗输尿管上段嵌顿结石疗效可靠,并发症少,可作为输尿管上段嵌顿结石的首选治疗方法。

Comparison of minimally invasive percutaneous nephrolithotomy and transurethral ureteroscopic lithotripsy for obstructive upper ureteric calculi

OBJECTIVE To compare the efficacy of minimally invasive percutaneous nephrolithotomy(MPCNL)and transurethral ureteroscopic lithotripsy(URL)for obstructive upper ureteric calculi.METHODS 85 cases of impacted upper ureteral stones were randomly divided into observation group and control group,respectively received MPCNL and URL,then the hospital stay,operative time,blood loss,complications and stone clearance rate of two groups were compared.RESULTS The operative time,blood loss,hospitalization time of observation group were(64.3 ± 15.6)min,(123.5 ± 38.2)ml,(13.2 ± 2.1)d,which were significantly higher than control group,the differences between groups were statistically significant(P﹤0.05);the stone clearance rates of observation group in the 3d and 1 month postoperation were 93.0% and 97.7% respectively and which were significantly higher than control group,the differences between groups were statistically significant(P﹤0.05);the incidence of complications between groups had no statistically difference(P﹥0.05).CONCLUSION MPCNL for treatment of upper ureteral calculi has reliable efficacy,fewer complications and it can be the preferred treatment for impacted upper ureteral stones.