经皮肾镜微通道气压弹道碎石和输尿管硬镜钬激光碎石治疗输尿管上段嵌顿性结石的效果比较

Comparison of the Effect of Percutaneous Nephrolithotomy with Micro Channel Pneumatic Lithotripsy and Ureteroscopic Holmium Laser Lithotripsy in Treatment of Upper Ureteral Incarcerated Calculi

目的:探究经皮肾镜微通道气压弹道碎石(MPCNL)和输尿管硬镜钬激光碎石对输尿管上段嵌顿性结石的治疗效果。方法:回顾性分析2014年6月-2017年6月本院收治的输尿管上段嵌顿性结石患者78例的临床资料。按照治疗方法不同将其分为A组(采用MPCNL治疗)和B组(采用输尿管硬镜钬激光碎石治疗),各39例。比较两组手术时间、住院时间、术中出血量、术后并发症及结石清除率。结果:A组手术时间明显少于B组,住院时间明显长于B组,术中出血量明显多于B组,比较差异均有统计学意义(P<0.05);A组术后并发症发生率明显低于B组,且术后1 d、1个月、3个月的结石清除率均明显高于B组,比较差异均有统计学意义(P<0.05)。结论:输尿管上段嵌顿性结石的治疗方法,应结合患者结石大小和肾脏积水等具体情况进行选择。

Objective:To explore the therapeutic effect of percutaneous nephrolithotomy with micro channel pneumatic lithotripsy(MPCNL)and ureteroscopic holmium laser lithotripsy in treatment of upper ureteral incarcerated calculi.Method:The clinical data of 78 patients with upper ureteral incarcerated calculi in our hospital from June 2014 to June 2017 were retrospectively analyzed.According to the different treatment methods,they were divided into group A(treated with MPCNL)and group B(treated with ureteroscopic holmium laser lithotripsy),39 cases in each group.The operative time,hospitalization time,intraoperative blood loss,postoperative complications and calculi clearance rate between two groups were compared.Result:The operative time of group A was significantly less than that of group B,the hospitalization time was significantly longer than that of group B,the intraoperative blood loss was significantly more than that of group B,the differences were statistically significant(P<0.05).The postoperative complication rate of group A was significantly lower than that of group B,and after operation 1 d,1 month and 3 months,the calculi clearance rate of group A were significantly higher than that of group B,the differences were statistically significant(P<0.05).Conclusion:The treatment of upper ureteral incarcerated calculi,should be combined with the size of patients with stones and hydronephrosis and other specific circumstances.