三种输尿管上段结石治疗方法的临床比较  

A comparative study of three therapeutic methods for upper ureteral calculi

作　　者：文卫军[1] 石宇强[1] 郭晓辉[1] 曾桓聪[1] 邵海斌[1] 

机构地区：[1]广州中医药大学附属顺德中医院泌尿外科,佛山528333

出　　处：《国际医药卫生导报》2011年第11期1310-1312,共3页International Medicine and Health Guidance News

摘　　要：目的探讨治疗上段输尿管结石的最佳方法。方法回顾分析我院2006年5月至2009年5月101例输尿管结石患者的外科治疗方法。A组应用小切口手术即输尿管上段切开取石术22例；B组应用微创经皮肾输尿管镜碎石术41例；C组应用后腹腔镜下输尿管切开取石术38例。分析比较三种方法在输尿管上段结石治疗中的差异。结果A、B、C三组碎石取石的操作时间分别为（38．04±3．70）min、（75．88±16．30）min、（131．05±13．03）min，A组显著小于其他两组（P〈0．01），B组明显小于c组（P〈0．01）。术后3天、1个月结石清除率三组分别为：A组95．4％、100％；B组97．6％、100％；C组94．7％、94．7％，三组之间差异无显著性。A组住院平均时间为（7．5±1）d，B组住院平均时间为（7.3±1）d，C组住院平均时间为（4．5±1．4）d，A、B两组住院时间明显大于C组（P〈0．01）。结论A、B、C三组均有很高的结石清除率，三种术式均有各自的优点。应根据具体情况选择不同的术式。Objective To explore the best therapeutic method for upper ureteral calculi. Methods The surgical procedures which had been performed on 101 patients with upper ureteral calculi during the period of May 2006 to May 2009 were retrospectively analyzed. Group A （ 22 patients ） received ureterlithotomy, group B （ 41 patients ） minimally invasive percutane nephrolithotomy, and group C （ 38 patients ） received retroperitoneal laparoscopic ureterolithotomy. The differences of these three procedures were compared and analyzed, Results The duration of calculus removal was markedly shorter in group A than in group B and it was shorter in group B than in group C （ [38.04 ± 3.70]min vs. [75.88 ±16.30] min vs. [131.05 ± 13.03]min, P 〈 0.01 for both comparisons ）. Three days and one month after the procedures, the stone-free rate was 95.4% and 100% for group A, 97.6% and 100% for group B, and 94. 7% and 94.7% for group C. The length of hospital stay was significantly longer in groups A and B than in group C （ [7.5 ±1[d vs. [7.3 ±1]d vs. [4.5 ± 1.4]d, P 〈 0.01 ）. Couclusions All the three groups have a higher rate of calculus removal. Three procedures have their own advantage. We shoule choose different procedures according to the actual situation.

关 键 词：输尿管上段结石 小切口输尿管切开取石术 微创经皮肾镜取石术 后腹腔镜 

分 类 号：R699[医药卫生—泌尿科学]