腹腔镜输尿管切开取石联合软镜取肾结石治疗输尿管中上段结石合并同侧肾结石的临床疗效研究分析  

Clinical analysis of the laparoscopic ureterolithotomy combined with ureter soft lens in treatment of middle and upper ureteral calculi and ipsilateral renal calculi

作　　者：许建挺[1] 鲁特飞[1] 

机构地区：[1]浙江省宁波市医疗中心李惠利医院,宁波315040

出　　处：《浙江创伤外科》2016年第2期222-225,共4页Zhejiang Journal of Traumatic Surgery

摘　　要：目的比较研究腔镜输尿管切开取石联合软镜取肾结石术和传统切开取石术对输尿管上、中段结石合并同侧肾结石的治疗效果。方法选取本院2013年6月至2015年6月收治的输尿管上、中段结石合并同侧肾结石65例,根据治疗方法不同将所有患者分为两组,微创组33例,行腹腔镜输尿管切开取石联合软镜取肾结石治疗,传统组32例,行传统切开取石治疗。观察两组手术时间、术中出血量、术后开始排尿时间、住院时间;两组术前术后1、3、6个月的的KPS评分;术后6个月两组并发症发生情况。结果两组术中及术后一般资料进行比较,结果发现,微创组的手术时间、术中出血量、术后开始排尿时间、住院时间均显著少于传统组,比较差异具有统计学意义(P<0.05);两组术前的KPS评分无显著差异,比较无统计学意义(P>0.05);微创组术后1、3、6个月的的KPS评分明显大于传统组,比较差异具有统计学意义(P<0.05);术后6个月随访结果显示,微创组的并发症发生率(6.06%)显著小于传统组(37.5%),比较差异具有统计学意义(P<0.05)。结论采用腹腔镜输尿管切开取石联合软镜取肾结石治疗输尿管中上段结石合并同侧肾结石的临床效果明显,较之传统手术,微创联合治疗对患者的创伤更小、结石清除更为彻底,并发症发生率低,有效缩短患者的恢复时间,适合临床选择使用。Objective To compare the therapeutic effect of the laparoscopic ureterolithotomy combined with ureter soft lens and ureterolithotomy in treatment of middle and upper ureteral calculi and ipsilateral renal calculi. Methods 65 cases of middle and upper ureteral calculi and ipsilateral renal calculi patients admitted in June 2013-June 2015 were included.The patients were divided into two groups. The minimally invasive group（33 cases） were treated with the laparoscopic ureterolithotomy combined with ureter soft lens.The traditional group（32 cases）were treated with ureterolithotomy.The operative time, blood loss, after urination, duration of hospitalization,KPS score 1,3,6 months before and after surgery, complications after 6 months were observed. Results The intraoperative and postoperative data were compared. The operative time, blood loss, after urination, duration of hospitalization of the minimally invasive group were significantly less than those of the traditional group（P 〈0.05）.There were no significant differences in KPS score before surgery between two groups（ P〉 0.05）.The KPS score 1,3,6 months after surgery of the minimally invasive group were significantly higher than those of the traditional group（P〈0.05）.The complications incidence of the minimally invasive group（6.06%） was significantly less than that of the traditional group（37.5%, P 〈0.05）. Conclusion The therapeutic effect of the laparoscopic ureterolithotomy combined with ureter soft lens and ureterolithotomy in treatment of middle and upper ureteral calculi and ipsilateral renal calculi was obvious.Compared with the traditional surgery, the minimally invasive treatment has less injury, more complete calculi clearance, less complication incidence and shorten recovery time. It＇s suitable for clinical use.patients for clinical choose to use.

关 键 词：输尿管中上段结石 肾结石 微创手术 传统手术 

分 类 号：R699.2[医药卫生—泌尿科学]