两种隧道式输尿管膀胱再植术治疗输尿管末端狭窄的比较

Comparison of Lich-Gregoir surgery and Politano-Leadbetter surgery for ureteral end stricture

目的比较膀胱外隧道式输尿管膀胱吻合（L ich-G regoir法）与膀胱内输尿管膀胱吻合（Politano-Leadbetter法）的有效性和安全性。方法回顾性分析我院2000年1月~2009年12月收治120例单纯输尿管末端梗阻并肾积水患者的临床资料。其中,行膀胱外隧道式输尿管膀胱再植术者79例,行膀胱内隧道式输尿管膀胱再植者41例,比较两种手术方式的手术时间、手术中出血量、术后留置尿管天数、并发症发生率及梗阻解除率等指标。结果两种手术方式的手术时间、术中出血量、术后住院时间、并发症率差异有统计学意义（P〈0.05）,而梗阻解除率及再狭窄发生率差异无统计学意义（P〉0.05）。结论膀胱外隧道式输尿管膀胱吻合术与膀胱内隧道式输尿管膀胱吻合相比治疗效果相同,但其他临床指标优于后者,更适合临床开展。

Objective To explore the therapeutic efficacy of Lich-Gregoir surgery and Politano-Leadbettr surgery.Methods The clinical data of 79 cases who underwent Lich-Gregoir and 41 cases who underwent Politano-Leadbetter surgery were compared.Results There were no significant differences in the mean restenosis rate（P0.05）,however,significant differences were found in the mean operation time,the mean intraoperative blood loss,the mean postoperative hospital stay between two groups（P0.05）.Conclusion Lich-Gregoir surgery and Politano-Leadbetter surgery have the same therapeutic effect,but the former had the better data on the other sides,it is more suitable for clinica.