输尿管硬镜激光碎石和腹腔镜切开取石治疗输尿管上端结石的疗效和并发症的比较

Clinical outcomes and complications of ureteroscopic laser lithotripsy versus laparoscopic stone removal in the treatment of upper ureteral calculi

目的探讨输尿管硬镜钬激光碎石和腹腔镜切开取石治疗输尿管上端结石的疗效和并发症的比较。方法选取本院2015年11月—2016年6月采用输尿管硬镜钬激光碎石的50例患者作为观察组,并回顾性分析2014年8月—2016年12月本院采用腹腔镜切开取石的30例患者作为对照组,对比2种方法治疗输尿管上端结石的临床效果及并发症的发生情况。结果观察组患者手术时间、住院时间均明显低于对照组(P<0.05),手术成功率及术后2个月结石清除率与对照组患者比较差异无统计学意义(P>0.05),观察组患者尿路感染、输尿管断裂、肾周积液例数与对照组比较差异无统计学意义(P>0.05),而对照组患者输尿管狭窄发生率明显高于观察组(P<0.05)。术前2组患者CRP、PCT水平比较差异无统计学意义(P>0.05),术后观察组以上指标明显低于对照组,差异有统计学意义(P<0.05)。结论采用输尿管硬镜钬激光碎石治疗嵌顿性输尿管上段结石对机体创伤较小,取石成功率高,值得临床推广运用。

Objective To evaluate the efficacy and complications of ureteroscopic holmium laser lithotripsy versus laparoseopie ureterolithotomy in the treatment of upper ureteral calculi. Methotis A total of 50 patients with ureteroscopic holmium laser lithotripsy from November 2015 to June 2016 in our hospital were as observation group, and 30 patients with laparoscopic ureterolithotomy in our hospital were as control group, clinical effect and complications were compared between the two methods. Results The operation time and hospitalization time in the observation group were signifi- cantly lower than that in the control group （ P 〈 0.05 ）. The success rate of operation and stone clearance rate at 2 months after operation showed no significant difference in the two groups （P 〉 0.05）. There were no significant differences in number of patients with urinary tract infection, ureteral rup- ture and perirenal fluid between the two groups （P 〉 0.05）, but the incidence of ureteral stricture in the control group was significantly higher than that in the observation group （P 〈 0.05）. There were no significant differences in CRP and PCT levels between the two groups before surgery （P 〉 0.05 ）. And the above indicators in the observation group were significantly lower than that in the control group （P 〈 0.05 ）. Conclusion Ureteroscopic holmium laser lithotripsy has less trauma and higher success rate for the treatment of upper ureteral calculi. So it is worthy of clinical application.