输尿管镜钬激光碎石术与经皮肾镜碎石取石术治疗复杂性输尿管上段结石的疗效比较

Comparison of efficacy,safety and economy of different minimally invasive surgery in the treatment of complicated upper ureteral calculi

目的探讨输尿管镜钬激光碎石术(UHL)、经皮肾镜碎石取石术(PCNL)治疗复杂性输尿管上段结石的有效性及安全性。方法选取60例复杂性输尿管上段结石患者作为研究对象,采用随机数字分组法分为研究组和对照组,研究组采用UHL术式进行治疗,对照组采用PCNL术式进行治疗,比较两组的术中和术后情况。结果研究组患者在手术碎石时间、术中出血量、住院时间、住院费用方面,均显著少于对照组,差异有统计学意义(P<0.05)。在术后7 d、1个月及3个月结石清除率方面,两组比较,差异无统计学意义(P>0.05)。治疗后,研究组的疼痛视觉模拟量表评分较对照组明显降低,差异有统计学意义(P<0.05)。与对照组相比,研究组患者术后并发症总发生率及复发率明显降低,差异有统计学意义(P<0.05)。结论 UHL术式治疗复杂性输尿管上段结石临床效果较好,住院时间较短,花费较少。

Objective To explore the clinical efficacy and safety of PCNL and UHL in the treatment of compli- cated upper ureteral calculi. Methods 60 cases of patients with complicated upper ureteral calculi were selected, Ac- cording to the random number table, 60 patients were divided into research group and control group, the study group was treated with UHL, and the control group was treated with PCNL. Results The operative time, blood loss, hospitalization time, hospitalization cost of the study group were significantly lower than control group, the differences between groups were statistically significant （ P 〈 0.05）. Compared with the control group, the stone clearance rate of 7 days, 1 months and 3 months after operation in the study group was no significant difference （P 〈 0.05 ）. After treatment, the VAS score was significantly lower than that of the control group （ P 〈0. 05 ）. Compared with the control group, the total incidence of postoperative complications and recurrence rate of the study group were significantly reduced （P 〈0. 05 ）. Conclusion The UHL has reliable efficacy in the treatment of complicated upper ureteral calculi with fewer complications and higher clinical application value.