后腹腔镜与经皮肾镜治疗输尿管上段结石的疗效分析

Efficacy analysis of retroperitoneoscopic ureterolithotomy and invasive percutaneous nephrolithotomy in the treatment of upper ureteral calculi

目的探讨输尿管上段结石的微创治疗方法选择。方法将80例输尿管上段结石患者随机分成两组，每组40例，分别行后腹腔镜输尿管切开取石术和经皮肾镜取石术治疗，比较两组结石清除率、并发症发生情况以及相关的临床资料。结果两组结石清除率、手术时间、术后住院时间差异均无统计学意义（P〉0．05）。腹腔镜组和经皮肾镜组术后平均出血量分别为（27±3）ml和（74±11）ml，并发症发生率分别为2．5％和20．0％，差异有统计学意义（P〈0．05）。结论两种方法治疗嵌顿性输尿管上段结石都是有效的微创治疗策略，经皮肾镜组术后并发症显著高于腹腔镜组，后腹腔镜输尿管切开取石术安全性高于微创经皮肾镜取石术。

Objective To investigate the minimally invasive therapy options for patients with upper ureterolithiasis. Methods Eighty patients with upper ureterolithiasis were randomly divided into two groups,each group contained 40 cases. They were treated with minimally invasive percutaneous nephrolithotomy（MPCNL） or retroperitoneoscopic ureterolithotomy （RPUL） respectively. The stone clearance rate, incidence of complications and related clinical datas were compared between the two groups. Resuits There were no significant differences in stone clearance rate, operation time and post-operation length of hospital stay between the two groups （P 〉 0. 05 ）. The incidence of complications in the MPCNL and RPUL group was 20. 0% and 2.5% respectively, post-operation average bleeding volume was （74 ± 11 ） ml and （27 ± 3） ml respectively, and there were significant differences between the two groups （P 〈 0. 05）. Conclusions Both of the MPCNL and RPUL are efficient therapy for patients with upper ureterolithiasis, but the incidence of complications and post-operation average bleeding volume in MPCNL group is significantly higher than those in the RPUL group. RPUL is more safer than MPCNL.