后腹腔镜与微通道经皮肾镜在输尿管上段结石治疗的应用分析

Therapeutic effect of retroperitoneal laparoscopic and microchannel percutaneous nephrolithotomy for upper ureteral calculi

目的探讨经后腹腔镜行输尿管切开取石术(RLU)与微通道经皮肾镜取石术(mPCNL)在治疗输尿管上段结石中的临床效果。方法选取于2015年1月至2019年3月在淮南市第一人民医院接受手术治疗的输尿管上段结石患者100例,其中行RLU治疗的患者50例(RLU组),行mPCNL治疗的患者50例(mPCNL组)。采用回顾性分析两组患者的手术持续时间、术后血红蛋白计数变化、术后住院时间、术后并发症发生率、术后1个月的结石清除率。结果两组术后1个月结石清除率比较,差异无统计学意义(P>0.05),RLU组术后住院时间短于mPCNL组,RLU组并发症发生率少于mPCNL组,RLU组术后血红蛋白下降量低于mPCNL组,mPCNL组手术时间短于RLU组,差异均有统计学意义(P<0.05)。结论mPCNL和RLU均为治疗输尿管上段结石的有效、安全的手术方式。两种手术方式各有特点,需要结合患者实际情况,选择合适的手术方式。

Objective To study clinical effects after laparoscopic ureterolithotomy(RLU)mi-crocannotal percutaneous renal calculus lithotripsy(mPCNL)in upper ureteral stones.Methods From January 2015 to March 2019 in Huainan first people s hospital,100 patients with upper ureteral calculi were selected,of which 50 patients underwent RLU surgery in the research group,and 50 pa-tients underwent mPCNL surgery in the control group.A retrospective analysis of the time of duration,changes in hemoglobin count after operation,postoperative hospitalization,postoperative complication probability,postoperative assessment stone free rate after 1 month of two groups was performed.The ef-fectiveness of the above two surgical methods was compared and explored.Results The rate of stone removal after 1 month was substantially the same in both groups.The difference was not statistically significant(P>0.05).The postoperative hospital stay in the RLU group was shorter than in the mPC-NL group(P<0.05).The RLU group had fewer complications than the mPCNL group(P<0.05),decreased hemoglobin postoperative RLU group was less than mPCNL grbup(P<0.05),mPCNL op-erating time was shorter than the RLU group(P<0.05).Conclusions mPCNL and RLU are effec-tive and safe surgical methods.The two surgical methods have their own characteristics,and it is necessary to select the appropriate operation method according to the actual situation of the patient.