复杂性输尿管上段结石并肾中重度积水的两种微创手术方法疗效比较

Comparision of Efficacy of Two Minimally Invasive Surgical Methods to the Complicated Upper Ureteral Calculi and Severe Renal Hydrocephalus

目的:探讨复杂性输尿管上段结石并肾中重度积水的两种微创手术方法的临床疗效。方法:选取笔者所在医院2013年5月-2015年5月进行治疗的160例复杂性输尿管上段结石并肾中重度积水患者随机分组,对照组患者应用输尿管镜下钬激光碎石治疗,试验组患者应用经皮肾镜下钬激光碎石术治疗。观察比较两组患者手术时间、术中出血量、住院时间、残石率、并发症发生率、患者满意度、二次手术率差异。结果:对照组在手术时间、住院时间、术中出血量有优势,但试验组残石率和二次手术率同对照组比较明显低,一次碎石成功率和满意度高,两组比较差异均有统计学意义(P<0.05)。两组均无并发症。结论:针对复杂性输尿管上段结石并肾中重度积水患者采用微创经皮肾镜钬激光碎石术是安全有效的。可提高单次碎石成功率、降低残石率,有效避免二次手术,同时可提高患者满意度及医院的美誉度。

Objective：To explore the clinical efficacy of the two minimally invasive surgical methods of complexity of ureteral calculi and severe renal hydrocephalus.Method：160 patients with complexity of ureteral calculi and severe renal hydrocephalus were treated from May 2013 to May 2015 in our hospital and divided into two groups,the patients of control group with holmium laser lithotripsy under ureter mirror treatment,the patients of experimental group under the application of percutaneous nephroscope holmium laser lithotripsy for treatment.Compared two groups of patients with operation time,intraoperative blood loss,hospital stay,the residual stone rate, incidence of complications,patients’ satisfaction,secondary surgery rate differences.Result：The control group had advantages in operation time,length of hospital stay and intraoperative blood loss,but the residual stone rate and secondary surgery rate were higher than the experimental group.Experimental group patients with residual stone rate and secondary surgery rate significantly decreased compared with controls,a success rate of gravel and satisfaction were high,the differences were statistically significant（P〈0.05）.The two groups were with none complications.Conclusion：It is safe and effective to use minimally invasive percutaneous holmium laser lithotripsy for the patients with complex upper ureteral calculi and severe water.It can improve the success rate and reduce the rate of residual stones of a single stone,effectively avoids the second operation and improve patient satisfaction and hospital reputation.