微创经皮肾穿刺取石和经尿道输尿管镜碎石治疗嵌顿性输尿管上段结石的疗效对比分析

Comparative Analysis of Minimally Invasive Percutaneous Nephrolithotomy and Transurethral Ureteroscopic Lithotripsy for the Treatment of Incarcerated Upper Ureteral Calculi

目的研究微创经皮肾穿刺取石(MPCNL)和经尿道输尿管镜碎石(URL)治疗嵌顿性输尿管上段结石的临床疗效。方法回顾分析2016年4月~2017年4月在我院治疗的108例嵌顿性输尿管上段结石患者,随机分为对照组和观察组,每组54例。对照组采用URL治疗,观察组采用MPCNL治疗,对比两组患者临床结石清除率、手术指标以及并发症发生情况。结果观察组术后清石率高于对照组,差异有统计学意义(P<0.05);观察组手术时间、住院时间、术中出血量、术后并发症发生率均低于对照组,差异有统计学意义(P<0.05)。结论 MPCNL治疗嵌顿性输尿管上段结石清石效果优于URL术,且术后并发症少,手术安全有效,可作为治疗嵌顿性输尿管上段结石的方法。

Objective To study the clinical effect of minimally invasive percutaneous nephrolithotomy(MPCNL)and transurethral ureteroscopic lithotripsy(URL)in the treatment of incarcerated upper ureteral calculi.Methods 108 patients with incarcerated upper ureteral calculi treated in our hospital from April 2016 to April 2017 were randomly divided into control group(n=54)and observation group(n=54).The patients in the control group were treated with URL,and the patients in the observation group were treated with MPCNL.The clinical stone clearance rate,surgical indexes and complications were compared between the two groups.Results The stone clearance rate in the observation group was significantly higher than that in the control group,the difference was statistically significant(P<0.05).The operative time,hospital stay,blood loss and postoperative complications in the observation group were significantly lower than those in the control group,the difference was statistically significant(P<0.05).Conclusion MPCNL is more effective than URL in the treatment of upper ureteral calculi.It has fewer complications and is safe and effective.It can be used as a method for the treatment of incarcerated upper ureteral calculi.