微创经皮肾镜取石术和后腹腔镜下输尿管切开取石术治疗输尿管上段结石的效果比较

Comparison of effectiveness of minimally-invasive percutaneous nephrolithotomy and retroperitoneal laparoscopic ureterolithotomy in the treatment of upper ureteral calculi

目的比较微创经皮肾镜取石(MPCNL)和后腹腔镜下输尿管切开取石(RLU)两种手术治疗输尿管上段结石的效果。方法回顾性分析2015年1~12月我院收治的202例输尿管上段结石患者,根据手术方式的不同分为MPCNL组(121例)和RLU组(81例)。比较两组的疗效,统计分析两组患者的手术时间、出血量、住院时间、一次碎石成功率、重复治疗率、并发症发生率、术后结石清除率。结果 RLU组的手术时间、住院时间短于MPCNL组,出血量少于MPCNL组,一次碎石成功率、术后结石一周清除率高于MPCNL组,重复治疗率、并发症发生率低于MPCNL组,差异有统计学意义(P<0.05)。结论 RLU治疗输尿管上段结石的手术时间和住院时间较短,出血量少,疗效优于MPCNL。

Objective To compare the efficacy of minimally-invasive percutaneous nephrolithotomy （MPCNL） and retroperitoneal laparoscopic ureterolithotomy （RLU） in the treatment of upper ureteral calculi.Methods Altogether 202 cases of up- per ureteral calculi patients who were treated in our hospital from January to December 2015 were retrospectively ana- lyzed and divided into the MPCNL group （121 cases） and the RLU group （81 cases） according to the different treatment methods.The efficacy of the two groups was compared and the statistical analysis of length of operation,the amount of bleeding,length of stay,one-time lithotripsy success rate,repeated treatment rate,the incidence rate of complications and postoperative stone clearance rate was statistically analyzed between the two groups.Results The length of operation and length of stay in the RLU group were shorter than those in the MPCNL group,the amount of bleeding in the RLU group was less than that in the MPCNL group,the one-time lithotripsy success rate and postoperative stone clearance rate in the RLU group were higher than those in the MPCNL group,the repeated treatment rate and the incidence rate of complications in the RLU group were lower than those in the MPCNL group,with statistically significant difference （P〈 0.05）.Conclusion The operation time and length of stay of RLU in the treatment of upper ureteral calculi is shorter and the amount of bleeding is less,the curative effect is better than that of MPCNL.