MPCNL术与FURL术治疗输尿管上段嵌顿性结石的效果对比分析

Comparison of effects of MPCNL and FURL in the treatment of incarcerate upper ureteric calculus

目的:比较经皮肾镜微通道气压弹道碎石(MPCNL)术与输尿管软镜钬激光碎石(FURL)术治疗输尿管上段嵌顿性结石的效果,探究更有效的治疗方案。方法:选取输尿管上段嵌顿性结石患者140例,随机分为A、B两组,各70例。A组行MPCNL术,B组行FURL术治疗。比较两组结石清除率、手术时间、住院时间、术中出血量及术后感染率。结果:术后3 d时A组结石清除率(100%)高于B组(81. 43%)(P <0. 05);术后1月及3月时,两组结石清除率无显著差异(P> 0. 05)。A组较B组手术时间更短(P <0. 05)、住院时间更长(P <0. 05)、术中出血量更多(P <0. 05)。术后感染率两组无显著差异(P> 0. 05)。结论:治疗输尿管上段嵌顿性结石,MPCNL术结石清除效果更好,但对患者创伤较FURL术大,临床应据患者情况合理选择治疗方案。

Objective:To compare the effects of microinvasive percutaneous nephrolithotomy with lithotomy(MPCNL)and transurethral flexible ureteroscope holmium laser lithotripsy(FURL)in the treatment of incarcerate upper ureteric calculus,and to explore a more effective treatment regimen.Methods:140 cases of patients with incarcerate upper ureteric calculus were selected and randomly divided into two group A and group B,with 70 cases in each group.Group A was treated with MPCNL,and group B was treated with FURL.The stone clearance rate,operative time,hospital stay,intraoperative blood loss and postoperative infection rate were compared between the two groups.Results:At 3d after operation,the stone clearance rate in group A was higher than that in group B(100.00%vs 81.43%)(P<0.05).There was no significant difference in the stone clearance rate between the two groups at 1 month and 3 months after operation(P>0.05).Compared with group B,group A had shorter operative time(P<0.05),longer hospital stay(P<0.05)and more intraoperative blood loss(P<0.05).There was no significant difference in postoperative infection rate between the two groups(P>0.05).Conclusions:In the treatment of incarcerate upper ureteric calculus,MPCNL has better stone clearance but has greater trauma than FURL,thus the treatment regimen should be based on the patients'condition in clinical practice.