摘要
目的:比较用后腹腔镜输尿管切开取石术与开放性手术治疗复杂性输尿管上段结石的效果。方法:选取梧州市红十字会医院泌尿外科收治的50例复杂性输尿管上段结石患者作为研究对象。按照手术方法的不同将其分为观察组(25例)与对照组(25例)。用后腹腔镜输尿管切开取石术对观察组患者进行治疗,用开放性手术对对照组患者进行治疗,然后比较两组患者的各项临床指标。结果:与对照组患者相比,观察组患者手术的时间更长,其术中的出血量更少,其术后住院的时间更短,术后第1天其血红蛋白(HGB)水平下降的幅度更小,P<0.05。两组患者结石的清除率、术后拔除引流管和导尿管的时间、术后第1天血清胱抑素C和肌酐的水平及术后并发症的发生率相比,P>0.05。结论:用后腹腔镜输尿管切开取石术治疗复杂性输尿管上段结石的效果与用开放性手术治疗此病的效果相当,不会增加患者术后并发症的发生风险,且具有术中的出血量少、术后患者恢复快及对其HGB水平的影响小等优点。
Objective:To compare the efficacy of retroperitoneal laparoscopic ureterolithotomy and open surgery in the treatment of complex upper ureteral calculi.Methods:50 patients with complicated upper ureteral calculi admitted to the Department of Urology,Wuzhou Red Cross Hospital were selected as research objects.The patients were divided into observation group(25 cases)and control group(25 cases)according to different surgical methods.Patients in the observation group were treated with retroperitoneal laparoscopic ureterolithotomy and patients in the control group were treated with open surgery.Then the clinical indicators of the two groups were compared.Results:Compared with the control group,the observation group had longer operation time,less intraoperative blood loss,shorter postoperative hospitalization time,and less decrease of hemoglobin(HGB)level on the first day after surgery(P<0.05).Compared with the rate of stone clearance,postoperative time of drainage tube and catheter removal,serum cystatin C and creatinine levels on the first day after surgery and the incidence of postoperative complications in 2 groups,P>0.05.Conclusion:The effect of retroperitoneal laparoscopic ureterolithotomy in the treatment of complicated upper ureteral calculi is similar to that of open surgery,without increasing the risk of postoperative complications,and has the advantages of less intraoperative blood loss,quick postoperative recovery and little effect on the HGB level.
作者
蒋团建
JIANG Tuanjian(Department of Urology,Wuzhou Red Cross Hospital,Wuzhou 543002)
