微创与开放式术式治疗肾盂输尿管连接部梗阻的临床疗效对比  

The comparison of clinical effect of laparoscopic pyeloplasty and open pyeloplasty in the treatment of ureteropelvic junction obstruction

作　　者：马为民[1] 臧任丽[2] 马志芳[1] 王芳[1] 李英慧[1] 陈予军[1] 

机构地区：[1]滨州市中心医院泌尿外科,251700 [2]滨州市中心医院影像中心,251700

出　　处：《国际医药卫生导报》2015年第20期2997-3000,共4页International Medicine and Health Guidance News

摘　　要：目的 探讨腹腔镜微创离断式肾盂成形术在肾盂输尿管连接部梗阻（UPJO）中的治疗价值.方法 根据患者或家属意愿,将86例UPJO患者分为微创组和传统组各43例.微创组采用腹腔镜微创离断式肾盂成形术,传统组采用开放性肾盂成形术.比较两组手术时间、术中出血量、术后止痛药使用量、术后肠道功能恢复时间、术后住院时间、术后并发症发生情况、术后肾积水复发率等指标.结果 微创组术中出血量[（29.8±4.1） ml]、术后止痛药使用量[（64.2±23.9） mg]、肠道功能恢复时间[（1.7±0.6）d]、住院时间[（7.3±2.5）d]均显著少于或短于传统组.微创组并发症发生率和肾积水复发率均显著低于传统组（x2=3.888、 4.962,P＜0.05）.结论 较之开放性肾盂成形术,腹腔镜微创离断式肾盂成形术可以促进UPJO患者术后康复,降低并发症发生率和肾积水复发率,是目前治疗UPJO较为理想的方法,值得临床推广运用.Objective To investigate clinical efficacy of laparoscopic pyeloplasty in the treatment ofureteropelvic junction obstruction （UPJO）.Methods 86 patients with UPJO were divided into minimally invasive group and traditional group with 43 cases in each group according to patients＆#39; or their families＆#39; will.Minimally invasive group was treated with laparoscopic pyeloplasty, while traditional group was treated with open pyeloplasty.The operation time, bleeding volume and the amount of analgesic usage after operation, recovery time, hospitalization time, postoperative complications, postoperative recurrence rate of hydronephrosis of two groups were compared.Results Bleeding volume and the amount of analgesic usage after operation, recovery time, hospitalization time of minimally invasive group [（29.8±4.1） ml, （64.2±23.9） mg, （1.7±0.6）d, （7.3±2.5） d] were significantly less or shorter than those of traditional group.The rate of postoperative complications and postoperative recurrence rate of hydronephrosis of minimally invasive group were significantly lower than those of traditional group （x 2=3.888, 4.962;P〈0.05）.Conclusion Compared with open pyeloplasty, laparoscopic pyeloplasty can promote the rehabilitation of patients with UPJO and reduce the rate of complication and recurrence rate of hydronephrosis, worthy of clinical application.

关 键 词：肾盂输尿管连接部梗阻 腹腔镜肾盂成形术 开放性肾盂成形术 

分 类 号：R692.705[医药卫生—泌尿科学]