两种嵌顿性输尿管上段结石微创处理方法比较

The comparison of two minimally invasive treatments for impacted upper ureteral calculi

目的:比较微创经皮肾镜取石术和输尿管镜取石术治疗嵌顿性输尿管上段结石的疗效及优缺点。方法:采用微创经皮肾镜(mPCNL)和输尿管镜(URL)治疗69例嵌顿性输尿管上段结石患者,比较两组碎石成功率及其他指标。结果:所有患者均耐受手术,无严重并发症发生,mRCNL组和URL组结石清除率分别为95.8%和71.1%(P<0.05),mRCNL组费用高于URL组,手术及住院时间也多于URL组(P<0.05)。结论:URL具有创伤小、恢复快等特点,但结石清除率低,术后常需辅助方法进一步清除残石。mRCNL取石术治疗输尿管上段结石清除率高,但手术时间及住院时间长,创伤较大,费用昂贵。

Objective：To compare the effect of minimally percutaneous nephrolithotomy（mPCNL） with ureteroscopic lithotripsy（URL） for impacted upper ureteral calculi.Methods：The sixty-nine patients were treated with minimally percutaneous nephrolithotomy（mPCNL） and ureteroscopic lithotripsy（URL）,the stone-free rate and other indexes of two groups were compared.Results：All patients underwent safely operation with no severe complications.The rates of stone-free in minimally percutaneous nephrolithotomy and ureteroscopic lithotripsy groups were 95.8% and 71.1%（P〈0.05）,the mean hospital cost in minimally percutaneous nephrolithotomy group was higher than that in ureteroscopic lithotripsy group（P〈0.05）,the mean hospital stay in minimally percutaneous nephrolithotomy group was longer than that in ureteroscopic lithotripsy group（P〈0.05）.Conclusions：The ureteroscopic lithotripsy for impacted upper ureteral calculi had few invasion but lower stone-free rate,the minimally percutaneous nephrolithotomy had higher stone-free rate but longer hospital stay and higher cost.