输尿管镜与经皮肾镜碎石术治疗输尿管上段结石效果比较

Comparison of transureteroscope holmium laser lithotripsy and percutaneous nephrotithotomy in treatment of upper-ureteral calculi

目的:比较经尿道输尿管镜碎石术(URL)与经皮肾镜碎石术(PCNL)治疗输尿管上段结石的效果。方法:对24例采用URL治疗(URL组)和19例采用PCNL治疗(PCNL组)的输尿管上段结石患者手术时间、术后住院时间、术后感染率、结石清除率及并发症发生率进行比较。结果:URL组手术时间和术后住院时间均短于PCNL组(P<0.01),2组术后结石清除率、感染率和并发症发生率差异均无统计学意义(P>0.05)。结论:输尿管上段结石位置偏低、肾脏积水少及不宜全麻的患者,可考虑首选URL手术。PCNL有一定创伤,对输尿管上段嵌顿结石、伴明显肾积水且结石位置近肾盂者,可有较好的疗效。

Objective： To investigate the effects of ureteroscope holmium laser lithotripsy（URL） and percutaneous nephrolithotripsy（PCNL） in management of upper urinary tract calculi.Methods： Forty-three patients with upper ureter calculi were included in the study.Twenty-four of them were treated by URL（URL group） and 19 by PCNL（PCNL group）.The operation time,post-operative hospital stay,post-operative infection,stone-free rate and complication were compared between the two groups.Results： The operation time and hospital stay of the URL group were significantly shorter than those of the PCNL group（P 0.01）.The stone-free rate,postoperative infection and complication had no significant differences between the two groups（P 0.05）.Conclusions： URL is the best choice for patients whose ureteric calculi are located in a low position and have little hydronephrosis,or the patients who cannot undergo general anesthesia;PCNL is more suitable for patients whose ureteric calculi are in the upper part or near the pelvis with obvious hydronephrosis.