微创经皮肾穿刺碎石术治疗复杂性输尿管上段结石的临床研究

The effect of MPCNL in treatmentof complex proximal ureteral calculi

目的 探讨微创经皮肾穿刺碎石术（MPCNL）治疗复杂性输尿管上段结石的临床效果。方法 复杂性输尿管上段结石90例，根据治疗方式不同分为：观察组45例，采用MPCNL；对照组45例，采用经尿道输尿管镜下碎石术治疗（URL）。结果 观察组手术时间（112.5±12.4）min、手术出血量（51.3±3.7）ml,多于对照组［（34.8±10.5）min、（12.5±4.6）ml］（P〈0.05）；观察组手术成功率为95.6%、碎石率为97.8%,均高于对照组（71.1%、91.1%）（P〈0.05）。结论 URL在手术时间、术中出血优于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 explore the effect of MPCNL in the treatment of complex proximal ureteral calculi.Methods 90 cases were involved in treatment of complex proximal ureteral calculi in our hospital. MPCNL group were 45 cases and URL group surgery were 45 cases.Results The operation time,bleeding,single surgery success rate,stone-free rate after surgery success for URL and MPCNL were（34.8±10.5） minutes and （112.5±12.4） minutes,（12.5±4.6）ml and （51.3±3.7）ml,71.1% and 95.6%,91.1% and 97.8% respectively（P〈0.05）.Conclusions The operative time of URL is shorter, blood loss of URL is 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.