经皮肾输尿管镜与输尿管腔内碎石术治疗输尿管上段结石的手术指标与结石复发率比较

Comparison of Operative Index and Calculus Recurrence Rate of Ureteroscopic Lithotripsy and Percutaneous Nephroureteroscopic Lithotripsy in Treatment of Upper Ureteral Calculi

目的:探析输尿管腔内碎石术(URL)、经皮肾输尿管镜取石碎石术(PCNL)治疗输尿管上段结石的临床效果。方法:选取2016年1月-2017年7月本院收治的输尿管上段结石患者102例。按随机数字表法将其分为URL组与PCNL组,各51例。PCNL组给予患者PCNL治疗,URL组给予患者URL治疗。比较两组手术时间、术中出血量、住院时间、并发症(大出血、血尿、术后发热等)、首次碎石率以及结石复发率。结果:URL组术中出血量低于PCNL组(t=4.018,P<0.05);两组手术时间比较差异无统计学意义(t=0.415,P>0.05);PCNL组首次碎石率显著高于URL组(x^2=21.577,P<0.05);两组并发症发生率比较差异无统计学意义(x^2=0.018,P>0.05);URL组住院时间短于PCNL组(t=7.792,P<0.05);随访6个月,两组结石复发率比较差异无统计学意义(x^2=0.169,P>0.05)。结论:URL与PCNL两种碎石术治疗输尿管上段结石临床效果相近,利弊不同,具体应用中可根据患者情况选择不同的术式,从而提高临床效果。

Objective：To explore the clinical effect of Percutaneous nephroureteroscopic lithotripsy（PCNL） and ureteroscopic lithotripsy（URL） for upper ureteral calculi.Method：A total of 102 patients with upper ureteral calculi admitted to our hospital from January 2016 to July 2017 were selected.According to the random number table method,they were divided into URL group and PCNL group,51 cases in each group.PCNL group was treated with PCNL and URL group was treated with URL.The operation time,intraoperative blood loss,hospitalization time,complications（haemorrhage,hematuria,postoperative fever,et al）,first lithotripsy rate and calculus recurrence rate were compared between two groups.Result：The intraoperative blood loss in URL group was lower than that of PCNL group（t=4.018,P〈0.05）.The operation time of two groups was compared,the difference was not statistically significant（t=0.415,P〈0.05）.The first lithotripsy rate in PCNL group was significantly higher than that of URL group（ x2=21.577,P〈0.05）.The incidence of complications in two groups was compared,the difference was not statistically significant（ x2=0.018,P〈0.05）.The hospitalization time in URL group was shorter than that of PCNL group（t=7.792,P〈0.05）.After 6 months of follow-up,the calculus recurrence rate of two groups was compared,the difference was not statistically significant（ x2=0.169,P〈0.05）.Conclusion：URL and PCNL lithotripsy in treatment of upper ureteral calculi clinical effect is similar,advantages and disadvantages are different,specific application can be selected according to the patients＇ situation,so as to improve the clinical effect.