后腹腔镜与输尿管镜治疗输尿管上段嵌顿结石的临床效果观察

Observation of the Clinical Effect of Posterior Laparoscopy and Ureteroscopy in the Treatment of Incarcerated Stones in the Upper Ureter

目的:观察输尿管上段嵌顿结石应用后腹腔镜与输尿管镜治疗的效果.方法:选取2016年12月~2017年12月在本院诊治的98例输尿管上段嵌顿结石患者临床资料,按术式不同分2组,各组49例,对照组行输尿管镜碎石术,观察组行后腹腔镜输尿管切开取石术,比较两组围术期指标及并发症.结果:观察组手术时间(80.74±29.41)min比对照组长,出血量(32.01±3.85)mL比对照组多,但结石清除率(90.54±5.41)%比对照组高,且住院时间(4.85±0.74)d比对照组短(P<0.05);观察组术后并发症发生率6.12%比对照组的20.41%低(P<0.05).结论:后腹腔镜手术治疗输尿管上段嵌顿结石的结石清除率高,且术后较少并发症,建议首选该术式治疗.

Objective:To observe the effect of laparoscopy and ureteroscopy after the application of incarcerated stones in the upper part of the ureter.Methods:The clinical data of 98 patients with upper ureteral incarcerated calculi diagnosed and treated in our hospital from December 2016 to December 2017 were selected and divided into 2 groups according to different surgical procedures,49 cases in each group,and ureteroscopy lithotripsy was performed in the control group.The group underwent laparoscopic ureterotomy and stone removal,and compared the perioperative indicators and complications of the two groups.Results:The operation time of the observation group(80.74±29.41)min was longer than that of the control group,and the bleeding volume(32.01±3.85)mL was more than that of the control group,but the stone clearance rate(90.54±5.41)%was higher than that of the control group,and the hospital stay was(4.85±0.74)d was shorter than the control group(P<0.05);the postoperative complication rate of the observation group was 6.12%,which was lower than that of the control group(20.41%)(P<0.05).Conclusion:Posterior laparoscopic surgery for the treatment of upper ureteral incarcerated stones has a high stone clearance rate and few postoperative complications.It is recommended that this surgical treatment be the first choice.