经皮肾穿刺和经尿道输尿管镜碎石术治疗输尿管上段嵌顿结石的疗效比较

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

目的比较微创经皮肾镜取石术(MPCNL)与经尿道输尿管镜碎石术(URL)治疗输尿管上段嵌顿结石的疗效。方法68例单侧输尿管上段嵌顿结石的患者,34例采用URL治疗(URL组),34例采用PCNL治疗(PCNL组),分析比较两组患者的结石清除率。结果MPCNL组术后3d结石清除率为91.2%(31/34),术后1个月结石清除率为100%(34/34);URL组术后3d结石清除率为61.8%(21/34),术后1个月结石清除率为82.4%(28/34)。URL组的结石清除率明显低于MPCNL组(P<0.05)。结论MPCNL治疗输尿管上段嵌顿结石有很高的结石清除率;URL治疗效果稍差;MPCNL可作为输尿管上段嵌顿结石的首选治疗方法。

Objective To compare the efficacy between the minimally invasive percutaneous nephrolithotomy（MPCNL）and transurethral ureteroscope lithotripsy（URL） for obstructive upper ureteric calculi.Methods Of 68 cases with obstructive upper ureteric calculi 34 patients were received URL（URL group） and the other 34 patients were received PCNL（PCNL group）.And the stone-free rate were statistically analyzed.Results In PCNL group the stone-free rate was 91.2%（31/34）in 3 days postoperation and it was 100%（28/28）in a month postoperation. The Stone-free rate was 61.8%（21/34）in 3 days postoperation and it was 82.4%（28/34）in a month postoperation in PCNL group. Compared with URL Group,PCNL group got a higher stone-free rate both at 3 days and 1 month postoperation.Conclusion High stone-free rate can be obtained with MPCNL for obstructive upper ureteric calculi. The stone-free rate was less effective with URL. Therapy of the MPCNL may be choiced for obstructive upper ureteric calculi in the first place.