经皮肾镜取石术和输尿管镜取石术治疗复杂输尿管上段结石疗效比较  

The comparison of minimally invasive percutaneous nephrolithotomy and transurethral ureteroscope lithotripsy for complicated upper ureteric calculi

作　　者：李仙[1] 陈志健[1] 甘宏斌[1] 黄恒海[1] 

机构地区：[1]广西医科大学第七附属医院泌尿外科,广西梧州543001

出　　处：《华夏医学》2009年第1期21-23,共3页Acta Medicinae Sinica

基　　金：梧州市科学研究与技术开发计划项目(合同编号:200702004)

摘　　要：目的:探讨微创经皮肾镜钬激光碎石术(MPCNL)与经尿道输尿管镜钬激光碎石术(URL)治疗伴患侧肾中重度积水的复杂输尿管上段结石疗效。方法:伴患侧中重度肾积水、复杂输尿管上段结石63例,对30例行MPCNL治疗,33例行URL治疗。结果:MPCNL术成功率96.6%(29/30),手术后1周内结石清除率86.2%(25/29),术后1个月结石清除率为96.5%(28/29);URL术成功率78.8%(26/33),URL手术后1周内结石清除率19.2%(5/26),术后1个月结石清除率为76.9%(20/26)。结论:MPCNL治疗伴患侧肾中重度积水、复杂输尿管上段结石取石成功率高,结石残留率低,URL成功率较低,结石残留率高,MPCNL明显优于URL,有条件医院应作为首选。Objective：To investigate the effect of the minimally invasive percutaneous nephrolithotomy（MPCNL） with holmium laser in management of complicated upper ureteric calculi, comparing with transurethral ureteroseope lithotripsy（URL） with holmium laser. Methods ：A total of 63 patients were diagnosed as complicated upper ureteric calculi, 30 patients received minimal invasive percutaneous nephrolithotomy, 33 patients received transurethral ureteroscope lithotripsy. The stone-free rate was recorded in 7 days and 1 month postoperation. Results ： After MPC- NL, the stone-free rate was 86.2 % （25/29） in 7 days postoperation, and it was 96.5 % （28/29） in a month postoperation. After URL, the stone-free rate was 19.2% （5/26） in 7 days postoperation and it was 76.9% （20/26） in a month postoperation. Conclusions：High stone-free rate can be obtained with minimally invasive percutaneous nephrolithotomy for complicated upper ureteric calculi. The stone-free rate was less effective with transurethral ureteroscope lithotripsy. As to skilled urologists in conditioned hospitals, MPCNL can be considered to be fist choice for complicated upper ureteric calculi.

关 键 词：输尿管结石 输尿管镜 经皮肾穿刺取石术 

分 类 号：R693.4[医药卫生—泌尿科学]