不同取石方法在嵌顿性输尿管上段结石中的治疗对比

Comparison the healing effect between minimally invasive percutaneous nephrolithotomy and retroperitoneal laparoscopic ureterolithotomy for impacted upper ureteral calculi

目的对不同取石方法在嵌顿性输尿管上段结石中的治疗效果进行对比。方法选取该院收治的嵌顿性输尿管上段结石患者57例,根据手术方式不同分为腹腔镜输尿管切开取石术组(RLUL组)29例及微创经皮肾穿刺钬激光碎石术组(MPCNL组)28例。对两组患者术前各项基本资料、手术时间、结石清除率、血红蛋白下降情况、术后住院时间及并发症情况进行对比。结果研究发现,RLUL组手术时间[(71.5±11.6)min]与MPCNL组时间[(44.2±8.7)min]比较,差异有统计学意义(P<0.05)。RLUL组结石清除率(93.1%)高于MPCNL组(85.3%),差异无统计学意义(P>0.05)。RLUL组血红蛋白下降0.43g/L,MPCNL组下降0.78g/L,差异有统计学意义(P<0.05)。术后两组患者术后高热、肉眼血尿、输尿管狭窄以及术后尿漏对比,并发症差异无统计学意义(P>0.05)。结论 MPCNL和RLUL在复杂性上输尿管结石治疗中均有较高的结石清除率,术后恢复快及术后并发症少的优点。临床治疗时可根据医疗条件或者患者的病情作出适当的选择。

Objective Compare the healing effect of minimally invasive percutaneous nephrolithotomy and retroperitoneal laparoscopic ureterolithotomy in impacted upper ureteral calculi.Methods A total of 57 impacted upper ureteral calculi patients were selected in our hospital.Patients were divided into RLUL group（29 case） and MPCNL group（28 case）according to operation methods,to compare the basic material preoperative,operation time,stones clearance,hemoglobin down,postoperative hospitalization time and complications between two groups.Results Compare the material of two groups during preoperative shows,RLUL group′s operation time was 71.5＋11.6 min,MPCNL group was 44.2＋8.7 min,the difference has statistically significance（P0.05）.The stones clearance rate of RLUL group（93.1%） higher than the MPCNL group（85.3%）,but the result has no statistical significance（P0.05）.The hemoglobin down in RLUL group was 0.43 g/L,and 0.78% in MPCNL group,the result has statistical difference（P0.05）.The postoperative high fever,the naked eye hematuria,ureteral stricture and postoperative urine leakage shows there were no statistical difference between two groups（P0.05）.Conclusion Both MPCNL and RLUL in impacted upper ureteral calculi have high stones clearance rate,high postoperative recovery,and low surgical complications advantages.A proper choice can be made according to the condition of a specific patient and medical conditions.