输尿管镜钬激光碎石与后腹腔镜输尿管切开取石治疗上段输尿管结石的临床效果比较  

Comparison of clinical curative effect of ureteroscopy with holmium laser lithotripsy and retro-peritoneal laparoscope ureterolithotomy on treatment of upper ureteral calculus

作　　者：田丰[1] 董杰[1] 王龙信[1] 傅点[1] 程文[1] 王立新[2] 黄亮[2] 周凯[1] 

机构地区：[1]南京军区南京总医院泌尿外科,江苏南京210002 [2]解放军210医院泌尿外科,辽宁大连116021

出　　处：《东南国防医药》2014年第4期370-372,共3页Military Medical Journal of Southeast China

摘　　要：目的比较输尿管镜钬激光碎石术(URS)和后腹腔镜输尿管切开取石术(RPLU)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月上段输尿管结石70例的临床资料,其中行URS 38例,行RPLU 32例,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 URS组38例结石一次性取净率(直径无>4 mm结石残留)为86.8%(33/38),RPLU组32例结石一次性取净率为100.0%。URS组手术时间(85.63±14.01)min,术中出血量(11.18±7.11)mL,术后住院时间(3.95±1.51)d,术后并发症5例,RPLU组分别为(79.94±18.59)min,(20.94±10.96)mL,(4.53±1.24)d和0例。RPLU组在手术成功率上显著高于URS组,在术后并发症上也显著低于URS组(均P<0.05)。而在术中出血量上URS组则显著少于RPLU组(P<0.05)。在手术时间和术后住院天数上,两组比较差异无统计学意义(P>0.05)。结论 URS与RPLU比较,RPLU治疗上段输尿管结石手术成功率高,术后并发症少,而URS失血量少。Objective To compare the clinical effect of ureteroscopic holmium laser lithotripsy and retro -peritoneal laparo-scopic ureterolithotomy on treatment of upper ureteral calculus .Methods The data of 70 cases of hospitalized patients with upper ure-teral calculus between May 2011 and May 2012 were retrospectively studied .They were divided into ureteroscopy （ URS） with holmium laser lithotripsy group （38 cases） and retro-peritoneal laparoscopic ureterolithotomy （RPLU） group （32 cases）.The data of curative rate,operation time,blood loss,postoperation hospitalization time and complications were compared respectively .Results The curative rate （no calculus〉4 mm left） of URS group were 86.8% （33/38）,while the curative rate of RPLU group were 100.0%.In URS group,the operation time was （85.63 ±14.01） min,the blood loss was （11.18 ±7.11）mL,the postoperation hospitalization time was （3.95 ±1.51） d and the complication was 5 cases.While the data of these index in RPLU group were （79.94 ±18.59） min,（20.94 ±10.96） mL,（4.53 ±1.24） d and 0 case respectively.There were statistically significant difference in curative rate ,complication and blood loss between RPLU group and URS group （P〈0.05）.There was no statistically significant differences in operation time and postoperation hospitalization time between the two groups （P〉0.05）.Conclusion Comparing with URS,RPLU has advantage on higher curative rate and lower complications in the treatment of upper ureteral calculus .While the blood lose of URS is less .

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

分 类 号：R693.4[医药卫生—泌尿科学]