两种微创术治疗孤立肾输尿管上段结石的比较

Comparison of two minimally invasive procedures for upper ureteral calculi in solitary kidney

目的比较微造瘘经皮肾镜取石术(MPCNL)与后腹腔镜取石术(RLUL)在治疗孤立肾输尿管上段结石的临床价值。方法回顾分析该院45例微创术治疗孤立肾输尿管上段结石的临床资料。其中,MPCNL组29例,RLUL组16例,对比两组出血量、术后高热率(>38.5℃)、术后下床时间、住院总天数。结果 45例手术全部成功。MPCNL组出血量(120±50)mL、术后高热率(37.9%)、术后下床时间(5.0±1.5)d、住院总天数(7.0±3.5)d。RLUL组出血量(60±20)mL、术后高热率(6.2%)、术后下床时间(1.5±1.5)d、住院总天数(4.0±1.3)d。组间比较差异均有显著性(P<0.05)。结论治疗孤立肾输尿管上段结石RLUL术较MPCNL术更安全、有效。

[Objective] To evaluate the effect of minimally invasive percutaneous nephrolithotomy and retroperitoneal laparoscopic ureterolithotomy for the treatment of upper ureteral calculus in solitary kidney.[Methods] 45 patients with upper ureteral calculi enrolled in the study（29 cases were treated with MPCNL and 16 cases with RLUL） were compared to two sets of bleeding,postoperative fever rates（38.5℃）,postoperative bed time,total number of days after surgery.[Results] All operations were successful.the bleeding loss of MPCNL group was about（120±50）mL,high fever（37.9%）,bed time and total number of days are（5.0±1.5） and（7.0±3.5）d respective.Correspondence of RLUL group are（60±20） mL,6.2%,（1.5±1.5） and（4.0±1.3）d,showing statistically significant differences between group（P 0.05）.[Conclusion] The RLUL have a high success rate and is a safe and effective way for the treatment of upper ureteral calculus.