经尿道输尿管镜取石术与微创经皮肾镜取石术治疗输尿管上段结石的效果

Effect of ureteroscopy lithotripsy and minimally invasive percutaneous nephrolithotomy in the treatment of upper ureteral calculi

目的 探讨应用经尿道输尿管镜取石术(URL)与微创经皮肾镜取石术(MPCNL)治疗输尿管上段结石的效果。方法 106例输尿管上段结石患者,随机分为对照组及观察组,每组53例。对照组行MPCNL治疗,观察组行URL治疗。对比两组患者的入院治疗情况(包括手术时间、术中出血量、住院时间),术后3 d和术后1个月的结石清除情况。结果 观察组患者的手术时间(0.71±0.31)h、住院时间(4.82±0.71)d短于对照组的(1.72±0.39)h、(8.16±0.95)d,术中出血量(56.39±10.93)ml少于对照组的(140.13±39.85)ml,差异具有统计学意义(P<0.05)。观察组患者术后3 d和术后1个月的结石清除率分别为66.04%、84.91%,均低于对照组的90.57%、98.11%,差异具有统计学意义(P<0.05)。结论 URL与MPCNL治疗输尿管上段结石各具优势,URL创伤小、用时短、康复快,MPCNL结石清除率高,临床应根据实际情况选择合适的方式。

Objective To discuss the effect of ureteroscopy lithotripsy(URL) and minimally invasive percutaneous nephrolithotomy(MPCNL) in the treatment of upper ureteral calculi.Methods A total of 106 patients with upper ureteral calculi were randomly divided into control group and observation group,with 53 cases in each group.The control group received MPCNL treatment,and the observation group received URL treatment.The admission and treatment conditions(including operation time,intraoperative blood loss,and hospitalization time),and the stone clearance at 3 d and 1 month after surgery of the two groups were compared.Results The operation time(0.71±0.31) h and hospitalization time(4.82±0.71) d of the observation group were shorter than(1.72±0.39) h and(8.16±0.95) d of the control group,and the intraoperative blood loss(56.39±10.93) ml was less than(140.13±39.85) ml of the control group.All the differences were statistically significant(P<0.05).The stone clearance rate of the observation group at 3 d and 1 month after surgery of the observation group were 66.04% and 84.91%,which were lower than 90.57% and 98.11% of the control group,and the difference was statistically significant(P<0.05).Conclusion Both URL and MPCNL have their own advantages in the treatment of upper ureteral calculi.URL is less invasive,takes less time and has faster recovery,while MPCNL has a high stone removal rate,and the appropriate methods should be selected according to the actual situation.