三种不同治疗方案治疗输尿管上段结石的实效性对照探究

The effectiveness of patients with ureteral calculi with three different treatment

目的 探讨三种不同治疗方案治疗输尿管上段结石的实效性,为临床提供参考.方法 选取本院2013年1月至2014年1月期间收治的120例输尿管上段结石患者,将其分为A、B、C组,各40例,分别接受微创经皮肾镜取石术（MPCNL）、后腹腔镜输尿管切开取石术（RUL）、输尿管镜下碎石术（URL）,观察三组患者的手术时间、住院时间、碎石成功率等指标.结果 对三组患者的手术时间、并发症进行对比分析,差异有统计学意义（t=10.975,x2=9.082,P＜0.05）.对三组患者的住院时间、住院费用、碎石成功率及结石排尽率进行对比分析,差异有统计学意义（t=8.121、9.296,x2 =7.926、6.276,P＜0.05）.结论 对于输尿管上段结石疾病的判断及治疗,微创经皮肾镜取石术的清石成功率高,可以将其当作应该第一考虑的手术方式;后腹腔镜输尿管切开取石术安全,并发症较低,失血量少.输尿管镜下碎石术的碎石成功率低,患者出现并发症的发生率较高,应该谨慎考虑。

Objectives To observe the efficacy of patients with ureteral calculi treated with three different treatments.Methods 120 cases of patients with ureteral calculi were selected in our hospital from January 2013 to January 2014,divided into three groups with 40 cases of patients respectively.They were treated with percutaneous nephrolithotomy surgery （MPCNL）,ureterolithotomy laparoscopic surgery （RUL）,and ureteroscopy lithotripsy （URL）.The operative time,hospital stay,gravel and other indicators of success of patients were observed.Results For thc three groups of patients operative time,complications were analyzed,the difference was statistically significant （t =10.975,x2 =9.082,P 〈0.05）.after three groups of patients hospital stay,hospital costs,the success rate of gravel and stones drained rates were compared,the difference was statistically significant （t =8.121,9.296,x2 =7.926,6.276,P 〈0.05）.Conclusions For judgment and treatment of ureteral calculi segment disease,minimally invasive percutaneous nephrolithotomy clear stone success rate is high,it can be used as the first surgical procedure should be considered;ureterolithotomy after laparoscopic surgery safe,complications low,less blood loss.Ureteroscopy lithotripsy under rubble low success rate,patients with a higher incidence of complications,you should carefully consider.