输尿管软镜钬激光碎石与后腹腔镜输尿管切开取石术治疗输尿管上段结石的临床研究

Clinical study of flexible ureteroscope lithotripsy and retroperitoneal laparoscopic ureterolithotomy in the treatment of upper ureteral calculi

目的比较分析经输尿管软镜钬激光碎石术(FUHLL)和后腹腔镜输尿管切开取石术(RPLU)治疗输尿管上段结石的临床疗效。方法 51例输尿管上段结石患者,按治疗方法不同分为FUHLL组(25例)和RPLU组(26例)。FUHLL组给予FUHLL治疗,RPLU组给予RPLU治疗,分析两组患者手术成功率、手术时间、术中出血量、术后住院时间以及并发症情况。结果 FUHLL组患者手术时间、术中出血量、术后住院时间均优于RPLU组,差异有统计学意义(P<0.05)。FUHLL组手术成功率为92.00%,与RPLU组的96.15%比较,差异无统计学意义(P>0.05)。FUHLL组术后并发症发生率与RPLU组比较,差异无统计学意义(P>0.05)。结论 FUHLL和RPLU在治疗输尿管上段结石上成功率高,安全性好,并发症相对较少,具体使用哪种方法视病情而定。

Objective To compare and analyze the clinical curative effect of flexible ureteroscopic holmium laser lithotripsy （FUHLL） and retroperitoneal laparoscopic ureterolithotomy （RPLU） in the treatment of upper ureteral calculi. Methods A total of 51 upper ureteral calculi patients were divided by different treatment methods into FUHLL group （25 cases） and RPLU group （26 cases）. FUHL group received FUHLL treatment, and RPLU group received RPLU treatment. Analysis were made on operation success rate, operation time, intraoperative bleeding volume, postoperative hospital stay time, and complications in two groups. Results FUHLL group had better operation time, intraoperative bleeding volume, postoperative hospital stay time than RPLU group, and the difference had statistical significance （P〈0.05）. FUHLL group had no statistically significant difference in operation Success rate as 92.00%, comparing with 96.15% in RPLU group （P〉0.05）. FUHLL group had no statistically significant difference in incidence of postoperative complications comparing with RPLU group （P〉0.05）. Conclusion FUHLL and RPLU have high operation success rate, good security and less complications in the treatment of upper ureteral calculi, and it depends on disease to choose a specific method.