经后腹腔镜输尿管切开取石术对复杂性输尿管上段结石的临床效果

Effect of laparoscopic ureteral incision nephrolithotomy on the success rate and stone clearance rate in cases with complex upper ureteral calculi

目的分析复杂性输尿管上段结石患者采用经后腹腔镜输尿管切开取石术治疗的成功率及结石清除率。方法95例复杂性输尿管上段结石患者分为对照组47例和实验组48例,分别采用经尿道输尿管镜碎石取石术和后腹腔镜输尿管切开取石术治疗,对比分析两组治疗方式的手术成功率及结石清除率。结果对照组患者的手术时间、住院时间显著少于实验组(P<0.05),但是术中出血量差异无统计学意义(P>0.05);实验组患者的手术成功率(100%)、结石清除率(95.8%)高于对照组,术后并发症发生率(2.1%)低于对照组(17.0%),差异具有统计学意义(P<0.05)。结论与经尿道输尿管镜碎石取石术相比,经后腹腔镜输尿管切开取石术具有手术成功率高、风险小、术后并发症少等优点,可以作为复杂性输尿管上段结石治疗的首选方法。

Objective To find out the effect of laparoscopic ureteral incision nephrolithotomy on the success rate and stone clearance rate in the treatment of complex upper ureteral calculi. Method 95 patients having complex upper ureteral calculi were first chosen as the subjects of study. They were divided into an experimental group（ n = 48） and a control group（ n= 47）. The two groups were then subjected to laparoscope ureter incision nephrolithotomy and transurethral ureteroscopy lithotripsy respectively. The success rate of surgery and stone clearance rate of both groups were documented and compared.Findings The operation time and the length of hospitalization of the control group were significantly shorter than those of the experimental group（ P〈0. 05）. The difference between the two groups in intraoperatie blood loss was not statistically significant（ P〉0. 05）. The surgery success rate（ 100%） and the stone clearance rate（ 95. 8%） of the experimental group were much higher than those of the control group. The rate（ 2. 1%） of incidence of postoperative complications of the experimental group was significantly lower than that of the control group（ 17. 0%）. The difference was statistically significant（ P〈0. 05）. Conclusion As compared with transurethral ureteroscopy lithotripsy,laparoscope ureter incision nephrolithotomy is a more desirable technique in treating complex upper ureteral ureteral calculi as it engenders higher surgery success rate,fewer risks and fewer cases of complications.