应用经皮肾镜与输尿管软镜取石术治疗嵌顿性输尿管上段结石的疗效分析

Analysis about Clinical Effect of Incarcerated Upper Ureteral Stones Treated by Percutaneous Nephrolithotomy Surgery and Ureteroscopy Lithotripsy

目的:比较经皮肾穿刺取石术(PCNL)和输尿管软镜碎石术(FURL)在治疗上段输尿管嵌顿性结石中的疗效和术后情况,为手术方法的选择提供参考。方法:选择2013年1月2015年1月来我院就诊的120例输尿管上段嵌顿性结石患者,随机分组后应用经皮肾取石术和经输尿管软镜碎石术各治疗60例,比较两组患者的手术情况和一期疗效指标。结果:PCNL组的一个月后的结石清除率为91.7%,高于FURL组的81.6%,两组比较差异有统计学意义,两组的住院时间分别为(5.32±1.25)天和(3.21±0.64)天,经比较差异亦有统计学意义。两组的手术时间、术中出血量以及术后并发症发生率3项比较差异无统计学意义。结论:两种手术方法均疗效较好,经皮肾穿刺取石术一期结石清除率较高,但需要相对较长的时间来康复;而输尿管软镜碎石术创伤较小,更易恢复,但一期碎石效果不如PCNL。

Objective To compare the curative effect and postoperative conditions of percutaneous lithotripsy (PCNL) and flexible ureteroscope lithotripsy (FURL) in the treatment of upper ureteral calculi incarcerated stones, to provide a reference for the choice of surgical approaches. Methods 120 upper ureteral calculi incarcerated patients hospitalized from January 2013 to January 2015 in our hospital were 120 rando mLy grouped, with 60 per group to receive percutaneous nephrolithotomy or flex-ible ureteroscope lithotripsy treatment. The indexes for surgical efficacy of the two groups were compared. Results The stone clearance rate of PCNL group was 91.7%, higher than that of FURL group (81.6%) a month after surgery, with statistical signifi-cant, duration of hospitalization of the two groups were (5.32±1.25) days and (3.21±0.64) days respectively, and the difference was also statistically significant. However, operative time, blood loss and postoperative complication rates in the two groups were mostly the same, with no significant difference. Conclusion Efficacy of the two surgical methods were both acceptable.PCNL brings higher stone clearance rate, but requires a relatively long time to recover. While FURL method leaves less wound and is easier to come back to normal life, though the efficacy of one time is not as satisfying as PCNL.