经尿道输尿管镜碎石术与经皮肾镜取石术治疗复杂性输尿管上段结石的疗效比较  

Comparison on the Clinical Effect of URL and MPCNL in the Treatment of Complicated Upper Ureteral Calculi

作　　者：何安仁 刘桂勇[1] 万齐福 杜建兵[1] 王新[1] 宋洪飞[1] 

机构地区：[1]潜江市中心医院泌尿外科,湖北潜江433100

出　　处：《医学综述》2015年第2期371-372,共2页Medical Recapitulate

摘　　要：目的比较经尿道输尿管镜碎石术(URL)和经皮肾镜取石术(MPCNL)治疗复杂性输尿管上段结石的治疗效果。方法将2007年5月至2009年4月潜江市中心医院住院治疗的85例复杂性输尿管上段结石患者根据随机数字表法分为两组:URL组(45例)采用经尿道输尿管镜碎石治疗,MPCNL组(40例)采用经皮肾镜取石术治疗,比较两组术后住院治疗时间、碎石成功率、一次性碎石清除率、并发症等情况。结果 URL组及MPCNL组术中各出现1例肾出血和1例尿外渗并发症;URL组碎石成功率、术后住院时间及一次结石清除率均显著低于MPCNL组[71.1%比85.0%,(4.2±1.6)d比(7.1±1.9)d]8.22%比92.5%],差异均有统计学意义(P<0.05)。结论对于复杂性输尿管上段结石的微创治疗,应根据患者临床情况及实际要求制订治疗方案。Objective To compare the clinical effect of ureteroscopic lithotomy or lithotripsy（ URL）and minimally invasive percutaneous nephrolithotripsy（ MPCNL） in the treatment of complicated upper ureteral calculi. Methods A total of 85 patients with complicated upper ureteral calculi admitted to Qianjiang Central Hospital from May 2007 to Apr. 2009 were divided into 2 groups according to random number table method,patients in URL group URL（ 45 cases） were treated with ureteroscopic lithotomy or lithotripsy,and patients in MPCNL group（ 40 cases） were treated with minimally invasive percutaneous nephrolithotripsy.The postoperative hospitalization time,success rate of lithotripsy,disposable stone clearance rate,complications of the two groups were compared. Results One case of renal hemorrhage and one case of urinary extravasation occurred in both URL group and MPCNL group during operation. the success rates of lithotripsy,postoperative hospitalization time,rates of disposable stone clearance of URL group were significantly lower than those of MPCNL group [71. 1% vs 85. 0%,（ 4. 2 ± 1. 6） d vs（ 7. 1 ± 1. 9） d,82. 2% vs 92. 5%]（ P 0. 05）. Conclusion Concerning the minimally invasive treatment for complex upper ureteral calculi,the treatment plan should be made according to the actual requirements and clinical situation of patients.

关 键 词：复杂性输尿管上段结石 经尿道输尿管镜碎石术 经皮肾镜取石术 

分 类 号：R693.4[医药卫生—泌尿科学]