后腹腔镜输尿管切开取石术与微创经皮肾镜取石术治疗复杂性输尿管上段结石患者的疗效及安全性

Clinical efficacy and safety of retroperitoneal laparoscopic ureteral incision and minimally invasive percutaneous lithotripsy in the treatment of complicated upper ureteral calculi

目的探讨后腹腔镜输尿管切开取石术与微创经皮肾镜取石术治疗复杂性输尿管上段结石患者的疗效及安全性。方法选取2012年2月至2015年8月东莞市石排医院收治的200例复杂性输尿管上段结石患者作为研究对象,对200例患者的临床资料进行回顾性分析,其中95例患者(甲组)实施后腹腔镜输尿管切开取石术治疗,105例患者(乙组)实施微创经皮肾镜取石术治疗。比较两组患者手术时间、术中出血量、术后1周结石清除率、住院时间以及术后并发症发生率。结果两组患者手术时间、术中出血量比较,差异均有统计学意义(均P<0.05),但住院时间比较差异无统计学意义(P>0.05);甲组患者术后1周结石清除率及术后并发症发生率分别为100.0%、12.6%,乙组患者术后1周结石清除率及术后并发症发生率分别为96.2%、13.3%,组间比较差异均无统计学意义(均P>0.05)。结论后腹腔镜输尿管切开取石术与微创经皮肾镜取石术治疗复杂性输尿管上段结石均具有显著疗效,安全性均较高,临床应结合患者实际情况为其选择合适手术治疗方式。

Objective To investigate the efficacy and safety of retroperitoneal laparoscopic incision and minimally invasive percutaneous lithotripsy in the treatment of complicated upper ureteral calculi.Methods 200 cases of complicated upper ureteral calculi were selected from February 2012 to August 2015 in Dongguan City Shipai hospital as the research object,the clinical data of 200 cases were analyzed retrospectively, including 95 patients（group A） after the implementation of laparoscopic ureterolithotomy for the treatment,105 patients（group B） the implementation of minimally invasive percutaneous nephrolithotomy lithotomy treatment.The operation time,the amount of bleeding,the rate of stone removal,the length of hospital stay and the incidence of postoperative complications were compared between the two groups.Results Two groups of patients with operation time,intraoperative bleeding volume comparison, the differences were statistically significant（P〈0.05）,but the hospitalization time was no significant difference（P〉0.05）; 1 weeks the stone clearance rate was 100%,12.6% and the rate of postoperative complications of the patients after 1 weeks,the incidence rate of stone clearance were 96.2%,13.3% and the rate of postoperative complications of patients in group B,the difference between groups was not statistically significant（P〉0.05）.Conclusions Laparoscopic ureter lithotripsy and minimally invasive percutaneous nephrolithotomy treatment of complex upper ureteral calculi have a more significant effect,safety are high,clinical should be combined with the actual situation of the patient for the patient to choose the right surgery treatment.