RPLU和USHLL治疗输尿管上段结石的临床疗效比较

Comparison the Treatment of Retroperitoneal Laporoscoic Ureterolithotomy and Ureteroscopic Holmium Laser lithotripin of 168 Patients with Upper Ureteral Calculi

目的对比后腹腔镜输尿管切开取石术(RPLU)和输尿管镜钬激光碎石术(USHLL)治疗输尿管上段结石的临床效果。方法选取我院泌尿外科收治的168例输尿管上段结石患者,按手术意愿分成两组,输尿管镜组96例患者给予USHLL,后腹腔镜组72例患者接受RPLU。对比两组患者的手术时间、术中出血量、住院时间、手术成功率、一次性结石清除率以及术后并发症发生情况。结果与输尿管镜组相比,后腹腔镜组手术时间和术后住院时间较长,术中出血量较多(均P<0.05)。治疗后,后腹腔镜组手术成功率和一次性结石清除率均达到100.0%,高于输尿管镜组(P<0. 05)。后腹腔镜组术后并发症发生率为22. 22%,低于输尿管镜组的47. 92%(P<0.05)。结论后腹腔镜与输尿管镜手术治疗输尿管上段结石均可取得较为显著的临床疗效;后腹腔镜手术的手术成功率较高,一次结石清除更彻底,术后并发症发生率较低;输尿管镜手术的手术时间和术后住院时间较短,术中出血量较少。

Objective To investigate the clinical efficacy of retroperitoneal laporoscoic ureterolithotomy (RPLU) and ureteroscopic holmium laser lithotripsy (USHLL) in patients with upper ureteral calculi.Methods 168 patients with upper ureteral calculi were selected,and divided into two groups according to surgical intention.96 patients in the ureteroscopy group were received USHLL,and 72 patients in posterior laparoscopic were received RPLU. The operative time, intraoperative blood loss, hospitalization time,operation success rate, disposable stone clearance rate and postoperative complications were compared between the two groups. Results Compared with ureteroscopy group,the operation time and postoperative hospital stay were longer in the posterior laparoscopic group (all P<0.05).After treatment,the success rate and the removal rate of disposable stones in posterior laparoscopic group were 100. 0%, which were significantly higher than thoset of ureteroscopy group (P<0.05).The incidence of postoperative complications was 22.22% in the posterior laparoscopic group,which was significantly lower than that in the ureteroscopy group (P<0.05). Conclusion Posterior laparoscopic and ureteroscopic surgery for upper ureteral calculi can achieve a more significant clinical efficacy. The success rate of posterior laparoscopic surgery is higher,which can remove the stones thoroughly at once,and the incidence of postoperative complications is low. In ureteroscopic surgery,surgery time and postoperative hospital stay are shorter,and intraoperative blood loss is less.