镜钬激光碎石术与微创经皮肾镜碎石术治疗输尿管结石的对比研究

Comparative Study of Percutaneous Nephrolithotomy in the Treatment of Ureteral Calculi with Holmium:YAG Laser Lithotripsy and Minimally Invasive Mirror

目的探讨输尿管上段结石采用微创经皮肾镜碎石术与输尿管镜钬激光碎石术治疗效果对比。方法选取输尿管上段结石患者80例,随机分组,就输尿管镜钬激光碎石术(A组)与微创经皮肾镜激光碎石术(B组)治疗效果进行对比。结果 A组手术时间、住院天数少于B组。A组碎石成功率、结石排尽率均为92.5%,B组均为100%;A组并发症率为5%,B组为12%,差异有统计学意义(P<0.05)。结论采用的两种方法,均有优点。在输尿管上段结石中,输尿管镜钬激光碎石术并发症少,出血少,手术时间短,而微创经皮肾镜碎石法,有较高结石取尽率和排石成功率,故在结石停留时间长、结石较大的患者中较适用,需依据结石大小、部位、输尿管解剖、停留时间等,对微创方案进行选择。

Objective To investigate the upper ureteral calculi with minimally invasive percutaneous nephrolithotomy lithotripsy and ureteroscopic holmium laser lithotripsy for treatment effect comparison.Methods We selected 80 cases of upper ureteral calculi patients,randomly,then ureteroscopic holmium laser lithotripsy（A group） and minimally invasive percutaneous nephrolithotomy lithotripsy（B group） were compared and the effect of treatment.Results In A group,operation time,hospitalization days less than group B.In group A,the successful rate of lithotripsy,stone free rate was92.5%,B group was 100%; the A group complications rate was 5%,12% in B group,the difference was statistically significant（P〈0.05）.Conclusions The two kinds of methods using the,have advantage.In the upper ureteral calculi,ureteroscopy with holmium： YAG laser lithotripsy with fewer complications,less bleeding,short operation time,and minimally invasive percutaneous nephrolithotomy,have higher stone free rate and the stone expulsion rate,so in the stone stay a long time,for larger stones patients,need according to the stone size,location and ureteral anatomy,residence time,to choose the minimally invasive procedure.