输尿管镜钬激光碎石术与经皮肾镜碎石术治疗输尿管上段结石的比较研究

A comparative study of ureteral holmium laser lithotripsy and minimally invasive percutaneous nephrolithotomy in the treatment of upper ureteral calculi

目的比较输尿管镜钬激光碎石术与经皮肾镜碎石术在治疗输尿管上段结石的临床效果。方法选取本院2015年6月至2017年1月间收治的90例输尿管结石患者,随机分为观察组和对照组各45例,观察组采用输尿管镜下钬激光碎石术,对照组采用经皮肾镜碎石术,比较两组的治疗效果以及碎石成功率。结果观察组的手术时间、术中出血量以及术后住院时间均明显优于对照组,组间比较差异有统计学意义(P<0.05)。对照组的碎石成功率以及结石排出率均明显优于观察组,术后并发症发生率显著下降,差异有统计学意义(P<0.05)。结论对于结石较大、停留时间较长的输尿管上段结石,应用经皮肾镜治疗效果更好。如果输尿管结石较小,停留时间较短,而采用输尿管镜下钬激光碎石治疗更好。

Objective To evaluate the clinical effect of ureteroscopic holmium laser lithotripsy and percutaneous nephrolithotomy in the treatment of upper ureteral calculi.Methods A total of 90 patients with ureteral calculi admitted in our hospital from June 2015 to January 2017 were divided into observation group and control group randomly.The observation group was treated with ureteroscopic holmium laser lithotripsy treatment,the control group used percutaneous nephrolithotomy treatment.The treatment effect and gravel success rate were compared between the two groups.Results The operation time,intraoperative blood loss and postoperative hospital stay were significantly better than those of the control group,the difference was statistically significant（P〈0.05）.The success rate of the lithotripsy in the control group and the stone excretion rate were significantly better than those in the observation group.The incidence of postoperative complications was significantly decreased（P〈0.05）.Conclusion For the larger stones with longer duration of ureteral calculi,the effect of minimally invasive percutaneous nephrolithotomy is better.If the ureteral calculi smaller,shorter residence time,the use of ureteroscopic holmium laser lithotripsy treatment is better.