输尿管镜碎石取石术与微创经皮肾穿刺碎石取石术治疗复杂性输尿管上段结石疗效比较

Comparison of URL effect with MPCNL effect in treatment of complex proximal ureteral calculi

目的探讨输尿管镜取石术(URL)及微创经皮肾取石术(MPCNL)治疗复杂性输尿管上段结石的疗效及安全性。方法回顾性分析URL及MPCNL治疗复杂性输尿管上段结石127例的临床资料并对两种治疗方法进行比较。结果URL及MPCNL的手术时间分别为(36±6.5)及(120±13.8)min;单次手术成功率分别为71.2%及100%,手术成功后结石清除率分别91%及100%;术中出血分别为(12±3)及(55±5.5)mL;术后平均住院日分别为(3±1.3)及(6±1.6)d;住院费用分别为(4000±120)及(6500±150)元。结论URL在手术时间、术中出血、术后平均住院日、住院费用上优于MPCNL,但在手术成功率、结石清除率方面较MPCNL低。两种手术均安全可靠,无严重并发症。

[ Objective ] To evaluate clinical efficacy and safety of ureteroseopie lithotripsy （URL） and minimally invasive percutaneous nephrolithotomy （MPCNL） in the treatment of complex proximal ureteral calculi. [ Methods ] Clinical data of 127 cases diagnosed as complex proximal ureteral calculi were analyzed retrospectively and URL and MPCNL in the clinical aspects were compared. [Results ] The operation time, single surgery success rate, stone-free rate after surgery success, bleeding, postoperative hospital stay, hospital costs for URL and MPCNL were （36±6.5） minutes and （120± 13.8） minutes; 71.2% and 100%; 91% and 100%; （12 ± 3） mL and （55 ± 5.5） mL; （3 ± 1.3） days and （6 ± 1.6） days; （4000 ± 120） yuan and of （6500 ± 150） yuan, respectively. [Conclusion] The operative time and the average postoperative hospital stay of URL are shorter, blood loss and hospital costs of URL are less than those of MPCNL, but the success rate of surgery and stone-free rate of URL is not higher than those of MPCNL. Both treatment methods are safe and reliable without serious complications.