三种不同术式治疗输尿管狭窄的疗效及安全性分析

Efficacy and safety of three different surgical methods for ureteral stricture

目的:探究三种不同术式治疗输尿管狭窄(US)的疗效及安全性分析。方法:选取2015年1月-2018年1月收治的90例US患者为对象,根据手术方法的不同将其分为球囊扩张组、开放手术组和腹腔镜手术组各30例,比较三组的手术时间、术中出血量、术后住院时间、术后进食时间、近远期临床疗效及术后并发症。结果:球囊扩张组患者的手术时间、术中出血量、术后住院时间及术后进食时间均短于腹腔镜组和开放手术组(P<0.05),腹腔镜组手术时间、术中出血量、术后住院时间及术后进食时间均短于开放手术组(P<0.05);三组术后6个月临床疗效差异无统计学意义(P>0.05);术后1年球囊扩张组的总有效率明显低于腹腔镜组和开放手术组(P<0.05),但腹腔镜组和开放手术组的总有效率差异无统计学意义(P>0.05);术后球囊扩张组、腹腔镜组的总并发症率明显低于开放手术组(P<0.05),但球囊扩张组和腹腔镜组差异无统计学意义(P>0.05)。结论:球囊扩张术、开放手术组和腹腔镜手术治疗US的近期临床疗效相当,但球囊扩张术和腹腔镜手术在手术时间、术中出血量、术后住院时间、术后进食时间及并发症方面优于开放手术,而在长期疗效方面开放手术组和腹腔镜手术更具有优势,应根据患者的具体情况,选择合理的手术方式。

Objective:To explore the efficacy and safety of three different operative methods in the treatment of ureteral stricture(US).Method:Ninety US patients admitted to our hospital from January 2015 to January 2018 were divided into balloon dilatation group,open operation group and laparoscopic operation group.The operative time,intraoperative bleeding volume,postoperative hospitalization time,postoperative feeding time,short-term and long-term clinical efficacy and postoperative complications were compared among the three groups.Result:The operation time,postoperative hospitalization time and postoperative feeding time were shorter,and intraoperative bleeding volume was less in the balloon dilatation group than those in the laparoscopic group and the open operation group(P<0.05),and the operation time,postoperative hospitalization time and postoperative feeding time were shorter,and intraoperative bleeding volume was less in the laparoscopic group than those in the open operation group(P<0.05).The total effective rate in the balloon dilatation group was significantly lower than that in the laparoscopic group and the open operation group(P<0.05),but there was no significant difference between the laparoscopic group and the open operation group(P>0.05).There was no significant difference between the balloon dilatation group and the laparoscopic group(P>0.05).Conclusion:The short-term efficacy of balloon dilatation,open surgery and laparoscopic surgery for US was comparable,but balloon dilatation and laparoscopic surgery were superior to open surgery in terms of operation time,intraoperative bleeding volume,postoperative hospital stay,postoperative feeding time and complications,while open surgery and laparoscopic surgery were more effective in long-term outcomes.According to the specific conditions of patients,we should choose reasonable surgical methods.