后腹腔镜下输尿管上段切开取石术治疗输尿管上段结石的临床研究  

Clinical observation of retroperitoneal laparoscopic ureterolithotomy for upper ureteral calculi

作　　者：覃庆平[1] 王伟[1] 李刚[1] 刘杰[1] 周毅[1] 杨剑文[1] 姚远[1] 卢启海[1] 陈悦康[1] 陈翔[1] 

机构地区：[1]广西柳州市人民医院泌尿外科,柳州市545006

出　　处：《微创医学》2013年第3期270-273,共4页Journal of Minimally Invasive Medicine

基　　金：广西区卫生厅科研项目(合同号:Z2010059)

摘　　要：目的探讨后腹腔镜下输尿管上段切开取石术(RLU)的方法及临床疗效。方法对68例输尿管上段结石患者,采用RLU 50例(A组),其中前期15例(A1组)、后期35例(A2组),开放手术18例(B组),比较三组患者的临床资料。结果所有病例手术全部成功。A组术中出血量、术后镇痛剂使用率、术后下床活动时间及术后住院时间均少于B组,但住院费用高于B组。A2组与B组间手术时间差异无统计学意义,但均明显少于A1组(P<0.01)。结论 RLU具有出血量少、疼痛轻、恢复快及住院时间短等优点,但费用高、早期手术时间长,随着操作技术的熟练,手术时间显著缩短,可达开放手术水平。Objective To evaluate the method and clinical efficacy of retroperitoneoscopic ureterolitho- tomy（RLU）. Method 50 patients with upper ureteral calculi were performed with RLU （Group A, which included 15 early cases （ Group A1 ） and 35 late cases （ Group A2） ）, and 18 pa- tients with open operation （ Group B）. Clinical data of these three groups were compared. Results All cases were succeeded. Blood loss, postoperative analgesia rate, leaving bed time, and post- operative hospital stay were lower in Group A than in Group B, but treatment fee of Group A were higher than that of Group B. The operation time in Group A2 was much less than that in Group A1 and Group B （ all P 〈 0.05 ）. Conclusion RLU is superior to conventional surgery for less bleed- ing, less pain, faster recovery, and shorter hospitalization time, but with higher fee and long oper- ation time in the early stage. With the operation technology skilled, operation time was signifi- cantly shortened, and equal to the level of open operation.

关 键 词：后腹腔镜 输尿管上段结石 输尿管切开取石术 

分 类 号：R699[医药卫生—泌尿科学]