微创经皮肾镜取石术和经尿道逆行输尿管镜气压弹道碎石术治疗幼儿输尿管中上段结石的疗效对比  

Comparison of Minimally Invasive Percutaneous Nephrolithotomy and Transurethral Retrograde Ureteroscopic Pneumatic Lithotripsy in the Treatment of Upper Ureteral Calculi in Children

作　　者：韩桂强 HA N Gui-qiang(Department of Urology,Linqing People＇s Hospital,Linqing,Shandong Province,252600 China)

机构地区：[1]临清市人民医院泌尿外科,山东临清252600

出　　处：《中外医疗》2018年第25期13-15,共3页China & Foreign Medical Treatment

摘　　要：目的探讨微创经皮肾镜取石术(MPCNL)和经尿道输尿管镜取石术(URSL)治疗≤5岁输尿管中上段结石患儿的临床疗效和安全性。方法根据患儿住院号先后顺序从2012年3月—2015年3月在该院治疗的≤6岁输尿管中上段结石患儿中随机抽取80例作为研究对象,借助计算机相关程序将其平均分组,其中接受MPCNL治疗的设为观察组(40例),接受URSL治疗的设为对照组(40例),比较不同手术方案在疗效及观察指标方面的差异。结果观察组的手术时间和住院时间分别为(45.43±9.76)min和(8.12±1.03)d,明显短于对照组的(68.32±11.28)min和(13.45±2.34)d,差异有统计学意义(t=2.902、2.374,P<0.05);观察组的一期结石取净率100.0%(40/40)明显高于对照组的62.5%(25/40),差异有统计学意义(χ~2=4.596,P<0.05);两组术后HGB和HCT下降情况比较差异无统计学意义(P>0.05);观察组术后并发症发生率20.0%(8/40)明显低于对照组60.0%(24/40),差异有统计学意义(χ~2=13.33,P<0.05)。结论 MPCNL治疗幼儿输尿管中上段结石手术时间短,一期结石取净率高,围手术期并发症发生率低,较URSL安全高效,值得临床推广应用。Objective To investigate the clinical efficacy and safety of minimally invasive percutaneous nephrolithotomy （MPCNL） and transurethral ureteroscopic lithotripsy （URSL） in the treatment of children with ureteral calculi of ≤5 years old. Methods According to the sequence of the hospitalization order of children from March 2012 to March 2015, 80 patients with ureteral ureteral calculi in the 6-year-old ureter were randomly selected as study subjects, and they were averagely grouped by computer-related procedures. Among them, the patients who received MPCNL were treated as observation group （40 cases）, and those who received URSL treatment were set as control group （40 cases）. The differences in efficacy and observation indexes of different surgical procedures were compared. Results The operative time and length of stay in the observation group were （45.43±9.76） rain and （8.12±1.03）d, respectively, which were significantly shorter than those in the control group （68.32±11.28） rain and （13.45±2.34） d. The difference was statistically significant （t=2.902, 2.374, P〈 0.05）; the first-stage stone removal rate of the observation group was 100.0% （40/40）, which was significantly higher than that of the control group 62.5% （25/40）. The difference was statistically significant （χ2= 4.596, P〈0.05）; There was no significant difference in the reduction of HGB and HCT between the two groups （P〉0.05）; the postoperative complication rate in the observation group was 20.0% （8/40） significantly lower than that in the control group 60.0% （24/40）, the difference was statistically significant （χ2=13.33, P〈0.05）. Conclusion MPCNL has a short operation time in the treatment of ureteral upper ureteral calculi in young children. The net stone removal rate in one phase is high, and the perioperative complication rate is low. It is safer and more effective than URSL, and is worthy of clinical application.

关 键 词：输尿管结石 中上段 幼儿 经皮肾镜 输尿管镜 

分 类 号：R699.4[医药卫生—泌尿科学]