经尿道腔镜下取石术治疗输尿管结石伴肾积水的疗效  

Curative Effect of Transurethral Endoscopic Lithotomy on Ureteral Calculus with Hydronephrosis

作　　者：邸彦橙[1] 田河[1] 于峰[1] 张智慧[1] 白吉祥[1] 

机构地区：[1]牡丹江医学院红旗医院泌尿外科,黑龙江牡丹江157000

出　　处：《医学综述》2017年第3期561-564,共4页Medical Recapitulate

摘　　要：目的研究经尿道腔镜下取石术治疗输尿管结石伴肾积水的临床疗效。方法将2014年11月至2015年8月牡丹江医学院红旗医院收治的输尿管结石伴肾积水患者100例随机数字法分为对照组与观察组,各50例。对照组采用后腹腔镜输尿管切开取石术,观察组采用经尿道腔镜下取石术。比较两组患者术后的输尿管损伤程度、手术时间、首次手术成功率、术后住院时间、手术并发症等指标。结果输尿管上段结石术后观察组C反应蛋白(CRP)、血尿时间显著低于对照组[(34.6±4.4)mg/L比(38.9±4.6)mg/L,(4.5±1.1)d比(5.9±1.3)d,P<0.05];中下段结石术后观察组CRP、血尿时间显著低于对照组[(33.2±7.8)mg/L比(37.1±3.2)mg/L,(3.9±1.2)d比(5.5±1.7)d,P<0.05];输尿管上段手术中观察组手术时间显著短于对照组[(39±7)min比(58±9)min,P<0.05],住院时间差异无统计学意义(P>0.05)。输尿管中下段手术中观察组手术时间、术后住院时间显著短于对照组[(33±7)min比(59±10)min,(6.8±1.2)d比(8.2±1.0)d,P<0.05];对照组输尿管上段结石手术首次成功率显著高于观察组[100.0%(21/21)比80.8%(21/26),P<0.05];观察组出现术后并发症发生率显著低于对照组[8.0%(4/50)比30.0%(15/50),P<0.05]。结论经尿道腔镜下取石术对于输尿管上段结石伴肾积水有一定疗效,对于治疗输尿管中下段结石伴肾积水损伤小,疗效确切,操作简单,值得推广使用。Objective To investigate the clinical efficacy and safety of transurethral endoscopic lithotomy on ureteral calculus with hydronephrosis. Methods From Nov. 2014 to Aug. 2015,100 ureteral calculus patients with hydronephrosis in Hongqi Hospital of Mudanjiang Medical School were selected and divided into an observation group and a control group according to the random number method ,50 cases in each group. The control group was treated by laparoscopie ureterolithotomy, and the observation group was treated by transurethral endoscopic lithotomy. The injury of ureter, operation time, first operation success rate, postoperative hospitalization time and complications of the two groups were compared respectively. Results After treatment, the CRP and hematuria time of upper ureteric calculi patients in the observation group were significantly lower than that of the control group[ （34. 6±4.4） mg/L vs （38.9±4. 6） mg/L, （4. 5±1.1 ）d vs （5.9±1.3 ）d, P 〈 0. 05 ], and the same for patients with calculi in the middle and the distal part of ureter[ （33.2±7. 8 ） mg/L vs （37. 1±3.2 ） mg/L, （ 3.9±1.2 ） d vs （ 5.5±1.7 ） d, P 〈 0. 05 ]. The operation time of patients with upper ureteral calculi in the observation group was significantly shorter than the control group [ （39±7 ） min vs （58±9 ） rain, （ P 〈 0. 05 ） ], the difference of hospitalization time was not statistically significant （ P 〉 0.05 ）. The operating time and postoperative hospital stay of patients with distal ureteral calculus of the observation group were significantly shorter than those of the control group [ （ 33±7 ） min vs （59±10） rain, （6. 8± 1.2） d vs （ 8.2± 1.0） d, P 〈 0. 05 ].The first success rate of patients with upper ureteric calculi in the control group was significantly higher than the observa- tion group[100. 0% （21/21） vs 80. 8% （21/26） ,P 〈0. 05]. The complication rate of the observation group was signifi- cantly lower than the control group [ 8.0% （4/50�

关 键 词：输尿管结石 肾积水 尿道腔镜 

分 类 号：R699[医药卫生—泌尿科学]