头高脚低截石体位输尿管镜联合封堵器与微创经皮肾镜治疗输尿管上段嵌顿性结石的效果对比  

Effect comparison of ureteroscopy in reverse Trendelenburg stone lithotomy position combined with occluder and minimally invasive percutaneous nephrolithotomy in the treatment of upper ureteral incarcerated calculi

作　　者：刘聪 李四化 黄丽丽 赖在驰 范翰共 LIU Cong;LI Si-hua;HUANG Li-li;LAI Zai-chi;FAN Han-gong(Department of Urology, Shanwei Yihui Fund Hospital, Guangdong Province, Shanwei 516600, China)

机构地区：[1]广东省汕尾逸挥基金医院泌尿外科,广东汕尾516600

出　　处：《中国当代医药》2019年第4期107-110,共4页China Modern Medicine

基　　金：广东省汕尾市科技计划项目(2017C011)

摘　　要：目的比较头高脚低截石体位输尿管镜联合封堵器与微创经皮肾镜治疗输尿管上段嵌顿性结石的安全性及有效性。方法选取2017年1月1日～2018年12月31日我院收治确诊为输尿管上段嵌顿性结石(结石位置在腰4以上)且行微创手术治疗的85例患者作为研究对象,根据治疗方法的不同将其分为观察组(44例)和对照组(41例)。其中行输尿管镜联合封堵器者为观察组,采用钬激光碎石治疗;行微创经皮肾镜者为对照组,采用气压弹道碎石治疗。比较两组患者的碎石成功率、结石清除率、手术时间、住院时间、住院费用及并发症发生情况。结果观察组患者的碎石成功率为95.4%,结石清除率为95.2%,分别与对照组的100.0%、97.6%比较,差异无统计学意义(P>0.05)。观察组患者的手术时间、住院时间均短于对照组,住院费用、并发症总发生率均低于对照组,差异有统计学意义(P<0.05)。结论头高脚低截石体位输尿管镜联合封堵器与微创经皮肾镜均是治疗输尿管上段嵌顿性结石效果较好的手术方式。头高脚低截石体位输尿管镜联合封堵器术后并发症发生率更低,安全性更高,是治疗输尿管上段嵌顿性结石较好的选择。Objective To compare the safety and effectiveness of ureteroscopy in reverse Trendelenburg stone lithotomy position combined with occluder and minimally invasive percutaneous nephrolithotomy in the treatment of upper ureteral incarcerated calculi. Methods Eighty five patients who underwent minimally invasive surgeries for upper ureteral incarcerated calculi (with stone position above the lumbar vertebra 4) in our hospital from January 1, 2017 to December 31, 2018 were selected as research objects. According to different treatment methods, they were divided into observation group (n=44) and control group (n=41). The ureteroscope combined with occluder was used in the observation group, and holmium laser lithotripsy was given. In the control group, the minimally invasive percutaneous nephroscope was given, and the pneumatic ballistic lithotripsy was adopted. The success rate of the lithotripsy, stone clearance rate, operation time, hospitalization time, hospitalization cost and complications were compared between the two groups. Results The success rate of lithotripsy in the observation group was 95.4%, and the stone clearance rate was 95.2%, which were not significantly different from those in the control group respectively accounting for 100.0% and 97.6%(P>0.05). The operation time and hospitalization time in the observation group were shorter than those in the control group, the hospitalization cost and the total incidence of complications were lower than those in the control group, and the differences were statistically significant (P<0.05). Conclusion The ureteroscopy in reverse Trendelenburg stone lithotomy position combined with occluder and minimally invasive percutaneous nephrolithotomy are both effective methods for the treatment of incarcerated calculi in the upper ureter. The incidence rate of postoperative complications was lower and safety was higher in the ureteroscopy in reverse Trendelenburg stone lithotomy position combined with occlude, which is a better choice for the treatment of incarcerated c

关 键 词：封堵器 头高脚低截石体位 输尿管镜碎石取石术 微创经皮肾镜 

分 类 号：R699.4[医药卫生—泌尿科学]