经后腹腔镜与输尿管镜治疗输尿管上段结石的疗效比较  

Comparative study of therapeutic effects between retroperitoneoscopic ureterolithotomy and uretero-scopic lithotripsy for upper ureteral calculi

作　　者：周忠兴[1] 刘伟民[1] 邹建纲[1] 吴小鹏[1] 陆曙炎[1] 

机构地区：[1]南京医科大学附属常州市第二人民医院泌尿外科,213003

出　　处：《中华泌尿外科杂志》2013年第5期343-346,共4页Chinese Journal of Urology

摘　　要：目的比较经后腹腔镜与输尿管镜治疗输尿管上段结石的疗效。方法回顾性分析2002年1月至2012年10月120例后腹腔镜下输尿管切开取石术和108例输尿管镜下气压弹道碎石术及钬激光碎石术治疗输尿管上段结石患者的临床资料。后腹腔镜组与输尿管镜组结石长径分别为（1．56±0．52）、（1．44±0．46）cm，肾盂分离分别为（2．85±0．86）、（2．76±0．82）cm，体质指数分别为（23．65±2．80）、（22．54±2．68）kg／m^2，组间比较差异均无统计学意义（P〉0．05）。比较两组手术时间、术后住院时间、手术成功率、结石清除率及手术并发症等指标。结果后腹腔镜组与输尿管镜组手术时间分别为（75．5±25．8）、（62．5±15．3）min，术后住院时间分别为（6．2±1．2）、（4．0±0．8）d，手术成功率分别为95．0％（114／120）、85．2％（92／108），并发症发生率分别为3．5％（4／114）、17．4％（16／92），结石清除率分别为100．O％（114／114）、89．1％（82／92），组间比较差异均有统计学意义（P〈0．05）。结论经后腹腔镜与输尿管镜治疗输尿管上段结石都有创伤小、恢复快等优点。后腹腔镜下输尿管切开取石术较输尿管镜下碎石术手术成功率高、并发症少，对有腹腔镜手术经验的术者是一种安全有效的方法。Objective To compare the effect of retroperitoneoscopic ureterolithotomy （RPUL） and ureteroscopic lithotripsy （URL） for upper ureteral calculi. Methods One hundred and twenty cases trea- ted by RPUL and 108 cases by URL from January 2002 to October 2012 were reviewed. In RPUL and URL group, the diameter of stone was （ 1.56 ± 0.52） cm vs （ 1.44 ± 0.46） cm, ipsilateral hydronephrosis was （2.85 ±0.86） cm vs （2.76 ±0.82） cm, body mass index was （23.65 ±2.80） kg/m2 vs （22.54 ±2.68） kg/m2. There were no signficant differences. Data on the operation time, the hospital stay after operation, the operation, successsful rate, complication incidence and stone-free rate were compared between the 2 groups. Results Comparisons between RPUL group and URL group included the following： the operation time was （75.5 ± 25.8） min vs （62.5 ± 15.3 ） min, the hospital stay after operation was （6.2 ± 1. 2） d vs （4.0 ± 0.8） d. There were significant differences. The operation successful rate was 95.0% （114/120） in RPUL group and 85.2% （92/108） in URL group. The complications incidence rate was 3.5% （4/114） in RPUL group and 17.4% （16/92） in URL group. The stone-free rate was 100.0% （114/114） in RPUL group and 89.1% （82/92） in URL group. The differences were significant （P 〈 0.05 ）. Conclusions RPUL and URL had the advantages of less trauma and blood loss and rapid recovery. RPUL had fewer com- plication and higher success rate than URL, and could be a minimally invasive option for the treatment of ureteral calculi.

关 键 词：输尿管结石 腹腔镜检查 输尿管镜检查 碎石术 治疗结果 

分 类 号：R699.4[医药卫生—泌尿科学]