后腹腔镜输尿管切开取石术治疗复杂性输尿管上段结石103例疗效观察  

Clinical effect of the treatment of 103 cases with complex upper ureteral calculi by retroperitoneal laparoscopic ureterolithotomy

作　　者：董永超[1] 王养民[1] 王生柱 康印东[1] 李卫平[1] 张伟君[1] 杨琦[1] 苗鹏程[1] 

机构地区：[1]兰州军区兰州总医院全军泌尿外科中心,兰州730050 [2]甘肃省康县第一人民医院

出　　处：《临床泌尿外科杂志》2015年第4期344-346,共3页Journal of Clinical Urology

基　　金：全军后勤科研面上项目(编号CLZ12J004)

摘　　要：目的：探讨后腹腔镜输尿管切开取石术（RLU）在治疗长径〉1cm的复杂性输尿管上段结石中的优劣。方法：回顾2010年1月-2012年12月,103例长径〉1cm的复杂性输尿管上段结石患者的临床资料,其中男61例,女42例。年龄21-63岁,平均41岁。对手术时间、结石一次性取尽率、并发症发生率、总治疗费用、效率商及患肾肾小球滤过率（GFR）恢复等方面进行统计学分析。结果：手术时间为（90±15）min;结石一次性取尽率97.1%;并发症发生率6.8%;总治疗费用（1.8±0.7）万元;效率商93.5%;术后6个月及12个月患肾GFR分别为（41.6±1.7）和（53.1±0.8）ml/min。结论：对于复杂性输尿管上段结石,当结石最大径〉1.0cm、结石≤3枚、结石距肾盂输尿管交界处〉3.5cm时RLU治疗效果好,但也有出现结石移位及输尿管狭窄等并发症的可能。Objective： To evaluate the advantages and disadvantages of retroperitoneal laparoscopic ureterolithotomy （RLU） in the treatment of the complex upper ureteral calculi （diameter 〉1 cm）. Method： The clinical data of 103 cases of complex upper ureteral calculi （diameter 〉1 era） from January 2010 to December 2012 were retrospectively reviewed. There were 61 males and 42 females, aged from 21 to 63 （average, 41） years old. The operation time, the stone-free rate, the complication rate, the total cost of treatment, the efficiency quotient and GFR of the affected kidney were statistically analyzed. Result： The results were as followed： the operation time was （90±15） mint the stone-free rate was 97.1% the complication rate was 6.8% ; the total cost of treatment was （1.8±0.7） ten thousand Yuan; the efficiency quotient was 93.5% GFR of the affected kidney 6 and 12 months after surgery was respectively （41.6±1.7） and （53.1±0.8） ml / min. Conclusion： For no more than three complex upper ureteral stones （maximum diameter 〉 1 cm） RLU is effective if the distance between the stones and ureteropelvic junction （UPJ） is more than 3.5 cm. However, patients may experience complications of shift stones and ureteral stenosis.

关 键 词：输尿管上段结石 后腹腔镜输尿管切开取石术 疗效 

分 类 号：R693.4[医药卫生—泌尿科学]