腹腔镜与小切口两种手术方式用于输尿管结石的疗效及安全性比较

Comparison of efficacy and safety of laparoscopic surgery and small incision surgery in the treatment of ureteral calculi

目的 观察比较腹腔镜与小切口两种手术方式用于输尿管结石治疗的疗效及安全性.方法 选取确诊的88例输尿管结石患者的临床资料进行回顾性分析,将其随机均分为两组,对所有患者进行密切护理和对症治疗,观察组采用腹腔镜手术治疗,对照组采用小切口手术方式治疗.对比观察两组患者手术后的疗效及并发症发生率,并比较两组患者的住院花费、痊愈时间及安全性.结果 观察组平均术中出血量低于对照组,而对照组平均手术时间少于观察组,差异均有统计学意义（P〈0.05）;观察组结石清除率为97.73%,对照组为100.00%,差异未见统计学意义（P〈0.05）.观察组术后下床走动时间和手术痊愈时间等指标均低于对照组,差异有统计学意义（P〈0.05）;观察组结石并发症发生率为4.55%,对照组为18.18%,差异有统计学意义（P〈0.05）.结论 小切口手术方式在治疗输尿管结石方面具有手术时间短、花费少及结石清除率高等优点,适合于基层医院开展;腹腔镜手术术中出血量少、创伤小、易恢复,且并发症少,值得推广.

Objective To observe and compare the efficacy and safety of laparoscopic surgery and small incision of surgery in the treatment of ureteral calculi.Methods The clinical data of 88 patients with ureteral calculi were retrospectively analyzed, they were randomly divided into two groups, with 44 cases in each group.Close care and symptomatic treatment for all patients, patients in control group were treated by small incision surgery, and patients in observation group were treated by laparoscopy.The efficacy and incidence of complications were compared between the two groups, and the hospital costs, recovery time and safety of the two groups were compared.Results The amount of bleeding in the observation group was lower than that in the control group during the operation, while the mean operation time in the control group was shorter than that in the observation group, the difference was significant （P〈0.05）;In the observation group, the stone clearance rate was 97.73%, while that in the control group was 100%, and there was no significant difference （P〈0.05）.The active time postoperation, patients recovery time, postoperative complication probability and other indicators in the observation group were lower than those in the control group, the differences were significant （P〈0.05）.In the observation group, the incidence of ureteral calculi was 4.55%, and that in the control group was 18.18%, the difference was significant （P〈0.05）.Conclusions Small incision surgery in the treatment of ureteral calculi has the advantages of short operation time, less cost and high stone clearance rate, is suitable for the basic hospital to carry out;Laparoscopic surgery has less bleeding, less trauma, easy recovery and less complications, significant curative effect, high safety, it is worth promoting.