经皮肾镜超声碎石术与输尿管钬激光碎石术治疗输尿管上段结石的疗效研究  

Comparative analysis of efficacy of percutaneous nephrolithotomy and holmium laser lithotripsy in treating proximal ureteral stones

作　　者：孙晓磊[1] 姜晓晓[1] 李约延[1] 朱海涛[1] 薛松[1] 陈家存[1] 孙晓青[1] 陈仁富[1] 

机构地区：[1]徐州医学院附属医院泌尿外科,徐州221000

出　　处：《国际外科学杂志》2015年第5期299-302,共4页International Journal of Surgery

摘　　要：目的 探讨经皮肾镜超声碎石取石术与输尿管钬激光治疗输尿管上段结石的临床疗效.方法 选取徐州医学院附属医院2012年12月-2014年10月收治的156例经B超及CT等影像学检查确诊为输尿管上段结石的患者作为研究对象.将156例患者按入院时住院号的末尾数字的单双号随机分为2组,对照组实施输尿管钬激光碎石术治疗,治疗组采用微创经皮肾镜碎石术治疗,观察并比较两组治疗效果,结石清除率,术后恢复以及并发症发生情况.结果 经皮肾镜组与输尿管钬激光组相比,手术时间分别为（28.6±7.4）min、（43.4±12.4） min,住院时间分别为（7.5±1.0）d、（4.2±1.3）d,手术成功率分别为100％、93.4％,结石清除率分别为100％、85.5％,残石率分别为0％、15.7％,差异均有统计学意义（p＜0.05）.经皮肾镜组并发症发病率明显低于输尿管钬激光组（P＜0.05）.术后发热发病率,两组分别为15％、6％,差异无统计学差异（P＞0.05）.结论 结石较小及离肾盂输尿管连接部较远时,建议采用输尿管钬激光碎石术;较大的输尿管上段结石及肾盂输尿管连接部结石建议采用经皮肾镜超声碎石取石术治疗.Objective To compare the clinical efficacy of percutaneous nephrolithotomy and holmium laser lithotripsy in the treatment of proximal ureteral stones.Methods One hundred and fifty-six patients with ureteral calculi diagnosed by B ultrasound,CT or other imaging were selected as research subjects in the Affiliated Hospital of Xuzhou Medical College from Dec.2012 to Oct.2014.All patients were randomly divided in to two groups according to the odd and even numbers at the last digit of the admission hospital number,of the control group conducted the ureter holmium laser lithotripsy and the treatment group conducted to minimally invasive percutaneous nephrolithotomy,observed and compared two groups therapeutic effect,stone clearance rate,postoperative recovery and complications.Results For the percutaneous nephrolithotomy group,operation time was （28.6 ± 7.4） minutes,hospitalization time was （7.5 ± 1.0）days,the rate of success of operation was 100,stones clearance rate was 100%,the residual stone rate was 0;For the holmium laser lithotripsy group,operation time was （43.4 ± 12.4） minutes,hospitalization time was （4.2 ± 1.3） days,the rate of success of operation was 93.4%,stones clearance rate was 85.5%,the residual stone rate was 15.7%.Compared with the holmium laser lithotripsy group,the percutaneous nephrolithotomy group had higher rate of success of operation,stones clearance rate and lower operation time,residual stone rate and complications.But hospitalization time was longer.Conclusions For smaller stones,holmium laser lithotripsy is better rather than percutaneous nephrolithotomy group.However,for larger stones,percutaneous nephrolithotomy operation is better than laser lithotripsy operation.

关 键 词：经皮肾镜超声碎石术 输尿管钬激光碎石术 疗效比较研究 结石 外科手术 

分 类 号：R692.4[医药卫生—泌尿科学]