两种常用微创方法治疗嵌顿性输尿管上段结石的效果比较

Effect comparison of two minimally invasive method commonly used in the treatment of impacted upper ureterolithiasis

目的探讨经皮肾镜取石术与经尿道输尿管镜下取石治疗嵌顿性输尿管上段结石的临床效果。方法选择43例患者使用皮肾镜取石术,并与43例使用经尿道输尿管镜下取石的患者比较两组患者手术时间和总住院时间,统计两组治疗期间发生的并发症。结果观察组取石成功率达到97.7%,显著高于对照组的83.7%(P<0.05),观察组发生术中出血的患者显著少于对照组(P<0.05)。结论经皮肾镜取石术相对于经尿道输尿管镜下取石,具有较高的手术成功率和较低的术后并发症,尤其适用于靠近肾盂的存在有严重肾积水的较大结石患者。

Objective To explore the clininal effect of percutaneous nephrolithotomy and retroperitoneoscopic ureterolithotomy in the treatment of impacted upper ureterolithiasis. Methods Forty-three patients with impacted upper ureterolithiasis were given percutaneous nephrolithotomy, 43 other patients with impacted upper ureterolithiasis were given retroperitoneoscopic ureterolithotomy, the operation time and total hospital stay were compared, the complications during treatment of two groups were statistical compared. Results The stone-taking successful rate in the observation group was 97.7%, which was significantly higher than 83.7% in control group （P 〈 0.05）, the intraoperatie bleeding in the observation group was significantly less than that in the control group （P 〈 0.05）. Conclusion Percutaneous nephrolithotomy, compared with the retroperitoneoscopic ureterolithotomy, has the high operation success rate of and lower postoperative complications, which is especially suitable to the patients with big calculus and serious hydronephrosis.