微创经皮输尿管镜在嵌顿性输尿管上段结石治疗中的应用

The Application of Minimally Invasive Percutaneous Ureteroscopy on Treating of Impacted Upper Ureteral Calculi

目的探究微创经皮输尿管镜与逆行输尿管镜治疗嵌顿性输尿管上段结石的疗效。方法将2010年3月至2013年3月来简阳市人民医院就诊的98例输尿管上段嵌顿性结石患者作为研究对象,其中选择微创经皮输尿管镜治疗的患者作为微创经皮输尿管镜组,采用逆行输尿管镜治疗的患者作为输尿管镜组,比较两组患者的碎石成功率、术后3 d及术后1个月的碎石清除率、手术时间、住院时间、住院费用等。结果经皮输尿管镜组患者的碎石率、术后3 d及术后1个月的碎石清除率均显著高于逆行输尿管镜组(P<0.05),其手术时间及住院时间均显著少于逆行输尿管镜组(P<0.05),但两者住院费用比较差异无统计学意义(P>0.05)。结论微创经皮输尿管镜治疗输尿管上段嵌顿性结石效果较逆行输尿管镜好,值得临床推广应用。

Objective To explore the effect of minimally invasive percutaneous ureteroscopy and retrograde ureteroscopy on treatment of impacted upper ureteral calculi.Methods Total of 98 cases with impacted upper ureteric calculi admitted to Jianyang People＇s Hospital during Mar.2010 and Mar.2013 were included as the research objects.Patients treated by minimally invasive percutaneous ureteroscopy as minimally invasive percutaneous ureteroscopy group,patients treated by retrograde ureteroscopy as ureteroscopy group.The achievement ratio of lithotripsy,the stones clearance rate on the third day and a month later after operation,operation time,the length of hospital stay and hospitalization expenses of the two groups were compared.Results The achievement ratio,the stone clearance ratethree days as well as one month after operation of minimally invasive percutaneous ureteroscopy group were obviously higher than that of ureteroscopy group（P ＜0.05）,and the operation time and the length of hospital stay were obviously shorter than that of ureteroscope group（P ＜ 0.05）,but the hospitalization expenses of the two groups had no statistically significant difference（P ＞ 0.05）.Conclusion The effect of minimally invasive percutaneous ureteroacopy treating impacted upper ureteral is better than retrograde ureteroscopy,thus is worth of spreading.