腹腔镜和输尿管镜治疗上输尿管结石的疗效对比

Comparison of curative effect on the laparoscope and ureteroscopes in the treatment of upper ureteral calculus

目的比较腹腔镜和输尿管镜治疗上输尿管结石的疗效。方法将70例上输尿管结石患者根据手术方法分为后腹腔镜输尿管切开取石术组(LAP组)和输尿管镜碎石术组(URE组),比较两组患者手术时间、术中出血量、住院时间和术后并发症的差异。结果 LAP组上输尿管结石35例手术均获成功,结石一次性取净率为100.0%;URE组35例手术均获成功,结石一次性取净率为91.4%(32/35)。LAP组手术时间(75.1±24.8)min,术中出血量(53.6±15.1)mL,住院时间(8.1±1.2)d;URE组分别为(93.5±27.2)min、(76.2±18.5)mL和(9.3±1.4)d;LAP组患者手术时间、术中出血量和住院时间显著低于URE组(均P<0.05)。两组患者术后并发症发生率差异无统计学意义(P>0.05)。结论腹腔镜手术治疗上输尿管疗效较输尿管镜高,具有微创和术后并发症少等优点。

Objective To compare the curative effect of the laparoscope and ureteroscopes in the treatment of upper ureteral calculus. Methods Seventy patients with upper ureteral calculus were divided into ureterolithotomy with retroperitoneoscopy group （LAP group） and ureteroscopy lithotripsy group （URE group）, the operation time, intraoperatve blood soss, length of stay and complication after operation of two groups were compared. Results There were 35 cases with upper ureteral calculus received successful operation in the LAP group, the stone free rate was 100.0%; there were 35 cases re- ceived successful operation in the URE group, the stone free rate was 91.4% （32/35）. In the LAP group, operation time was （75.1±24.8） min, intraoperatve blood soss was （53.6±15.1） mL, length of stay was （8.1±1.2） d;the same indexs in the URE group were （93.5±27.2） min, （76.2±18.5） mL, （9.3±1.4） d respectively; the operation time, intraoperatve blood soss, length of stay of LAP group were lower than that of URE group （all P 〈 0.05）. There was no significant difference in complication after operation between the two groups （P 〉 0.05）. Conclusion Laparoseope in the treatment of upper ureteral calculus has a better effect which compare with ureteroscopes, and it has some advantage such as minimal invasion and less complication.