后腹腔镜输尿管切开取石与输尿管镜钬激光碎石治疗输尿管上段结石的临床效果比较  

Comparison of clinical curative effect between retro-peritoneal laparoscopic ureterolithotomy and ureteroscopic holmium laser lithotripsy on treatment of upper ureteral calculus

作　　者：刘斌 田丰[2] 王立新[2] 黄亮[2] 王龙信[3] 董洁[3] 程文[3] 

机构地区：[1]南京建邺医院泌尿外科,江苏南京210017 [2]解放军第210医院泌尿外科,辽宁大连116021 [3]解放军南京军区总医院泌尿外科,江苏南京210002

出　　处：《临床军医杂志》2013年第12期1266-1268,共3页Clinical Journal of Medical Officers

摘　　要：目的比较后腹腔镜输尿管切开取石术(RPLU)和输尿管镜钬激光碎石术(UHLL)治疗输尿管上段结石的疗效。方法回顾性分析2011年5月—2012年5月收治的70例输尿管上段结石患者的临床资料,其中32例行RPLU,38例行UHLL,对比两组患者手术成功率、手术时间、术中出血量、术后住院时间和术后并发症的差异。结果 RPLU组32例结石一次性取净率为100.0%;UHLL组38例结石一次性取净率(无>4 mm结石残留)为86.8%(33/38)。RPLU组平均手术时间为(79.94±18.59)min,术中平均出血量为(20.94±10.96)ml,术后平均住院时间为(4.53±1.24)d,术后无并发症病例;UHLL组的上述参数分别为(85.63±14.01)min、(11.18±7.11)ml、(3.95±1.51)d和5例;RPLU组在手术成功率上显著高于UHLL组,在术后并发症上也显著低于UHLL组(均P<0.05)。而在术中出血量上UHLL组则显著少于RPLU组(P<0.05)。两组的手术时间和术后住院天数比较,无统计学差异(P>0.05)。结论 RPLU与UHLL比较,在治疗输尿管上段结石上手术成功率高,术后并发症少。Objective To compare the clinical effect between retro-peritoneal laparoscopic ureterolithotomy and ureteroscopic hol- mium laser lithotripsy on treatment of upper ureteral calculus. Methods A total of 70 hospitalized patients with upper ureteral cal- culus between May 2011 to May 2012 were studied retrospectively. They were divided into retro-peritoneal laparoscopic ureterolitho- tomy （RPLU） group （ n = 32） and ureteroscopic holmium laser lithotripsy （UHLL） group （ n = 38）. Curative rate, operation time, blood loss, post-operation hospitalization time and complication were compared between the two groups. Results The cura- tive rate of RPLU group was 100% （32/32） , while that of UHLL group （no calculus 〉 4mm left） was 86.8% （33/38）. In RPLU group, the average operation time was （79.94 ± 18.59） rain, the average blood loss was （20.94 ± 10.96） ml, the average post-operation hospitalization time was （4.53 ± 1.24） d and the case number of complication was 0. The counterparts in UHLL group were （85, 63 ± 14.01 ） rain, （ 11.18 ±7.11 ） ml, （3.95 ± 1.51 ） d and 5, respectively. There were statistically significant differences in curative rate, case number of complication and blood loss between the two groups （ P 〈 0.05 ）. There were no signifi- cant differences in operation time and post-operation hospitalization time （ P 〉 0.05）. Conclusion Comparing with UHLL, RPLU has advantage on higher curative rate and lower complication in the treatment of upper ureteral calculus.

关 键 词：输尿管上段结石 后腹腔镜输尿管切开取石术 输尿管镜钬激光碎石术 

分 类 号：R693.4[医药卫生—泌尿科学]