超声引导微通道经皮肾镜气压弹道碎石术与钬激光碎石术治疗复杂性输尿管上段结石

Ultrasound-guided Microchannel Percutaneous Nephrolithotomy Pneumatic Lithotripsy and Holmium Laser Lithotripsy for the Treatment of Complicated Upper Ureteral Calculi

目的:分析复杂性输尿管上段结石采用钬激光碎石术与超声引导微通道经皮肾镜气压弹道碎石术治疗的临床效果。方法:选取2013年5月-2016年8月笔者所在医院收治的复杂性输尿管上段结石患者100例,随机分为两组,每组50例,钬激光碎石术为对照组治疗方式,超声引导微通道经皮肾镜气压弹道碎石术为观察组治疗方式,比较两组临床疗效。结果:观察组结石清除率为96.00%,与对照组的94.00%比较,差异无统计学意义(P>0.05);观察组住院时间、术后血尿时间均短于对照组,比较差异均有统计学意义(P<0.05);观察组术后大出血、术后发热、输尿管穿孔发生率均低于对照组,比较差异均有统计学意义(P<0.05);观察组患者治疗总有效率为96.00%,与对照组的94.00%比较,差异无统计学意义(P>0.05)。结论:复杂性输尿管上段结石采用超声引导微通道经皮肾镜气压弹道碎石术治疗的临床效果更加显著,能对结石进行准确定位,值得推广。

Objective：To analyze the clinical effects of complicated upper ureteral calculi with holmium laser lithotripsy and ultrasound-guided microchannel percutaneous nephrolithotomy and pneumatic lithotripsy.Method：From May 2013 to August 2016,a total of 100 cases with complex upper ureteral stones admitted to the author＇s hospital were randomly divided into two groups with 50 cases in each group.The control group was treated with holmium laser lithotripsy treatment,and the observation group was treated with ultrasound-guided microchannel percutaneous nephrolithotomy pneumatic lithotripsy.The clinical efficacy was compared between the two groups.Result：The stone clearance rate in the observation group was 96%,compared with 94.00% in the control group,the difference was not statistically significant（P〉0.05）.The hospitalization time and postoperative hematuria in the observation group were shorter than those in the control group,and the differences were statistically significant（P〈0.05）.The incidences of postoperative hemorrhage,postoperative fever,and ureteral perforation in the observation group were lower than those in the control group,the differences were statistically significant（P〈0.05）.The total curative effect of the patients in the observation group was 96%,compared with 94% in the control group,the difference was not statistically significant（P〉0.05）.Conclusion：The use of ultrasound-guided microchannel percutaneous nephrolithotomy pneumatic lithotripsy for the treatment of complex upper ureteral calculi is more effective.It can accurately locate stones and is worthy of promotion.