Anderson-Hynes术式联合RIRS治疗UPJO的疗效及安全性分析  

Efficacy and Safety of Anderson-Hynes Combined with RIRS in the Treatment of UPJO

作　　者：张春锋 刘沛[1] 余泉峰 李泽宇 张冠英 李建昌[1] 吴春磊[1] ZHANG Chun-feng;LIU Pei;WU Chun-lei(The First Affiliated Hospital of Xinxiang Medical University,Xinxiang Henan 453100,China)

机构地区：[1]新乡医学院第一附属医院,河南新乡453100

出　　处：《湖北科技学院学报（医学版）》2020年第5期409-412,共4页Journal of Hubei University of Science and Technology(Medical Sciences)

基　　金：新乡医学院第一附属医院博士科研基金(xyyfy2014BS-003)。

摘　　要：目的探讨腹腔镜下Anderson-Hynes术式联合逆行输尿管软镜手术(RIRS)治疗肾盂输尿管连接部梗阻(UPJO)的临床疗效及安全性。方法选取我院手术治疗的61例UPJO肾积水患者,根据手术方法分为腹腔镜下Anderson-Hynes术式30例(A组)、腹腔镜下Anderson-Hynes术式联合RIRS治疗31例(B组),对比两组患者的手术时间、术中出血量、住院时间、手术前后患侧肾脏平均肾盂扩张分离的前后径(AP)、术后引流管留置时间、手术前后血肌酐(Scr)、肾小球滤过率、手术并发症。结果B组患者的手术时间、术后引流管留置时间均显著低于A组(P<0.05);两组患者术中出血量、住院时间比较,差异均无统计学意义(P>0.05);术前两组患者的AP值差异不具有统计学意义(P>0.05),术后6个月、术后1年,B组患者的AP值低于A组(P<0.05);术前、术后1年,两组患者的Scr、肾小球滤过率比较,差异均无统计学意义(P>0.05),两组患者术后1年Scr值较术前显著降低(P<0.05),肾小球滤过率较术前显著升高(P<0.05);A组患者的手术并发症率16.7%与B组患者6.4%比较,差异无统计学意义(P>0.05)。结论腹腔镜下Anderson-Hynes术式联合RIRS治疗UPJO较单纯腹腔镜下Anderson-Hynes手术能缩短手术时间、减少术后引流管留置时间、达到进一步减小AP值的目的。Objective To evaluate the clinical efficacy and safety of laparoscopic Anderson-Hynes combined with retrograde ureteroscopy(RIRS)in the treatment of ureteropelvic junction obstruction(UPJO).Methods Sixty-one patients with UPJO hydronephrosis were enrolled in our hospital from January 2015 to June 2018.According to the surgical procedure,30 cases(group A)underwent laparoscopic Anderson-Hynes,while 31 patients(group B)were treated with Anderson-Hynes combined with RIRS.The operation time,intraoperative blood loss,hospitalization time,anteroposterior diameter(AP)of the renal pelvic dilatation of the affected kidney before and after surgery,postoperative drainage tube indwelling time,Blood creatinine(Scr),glomerular filtration rate,and surgical complications before and after surgery were compared between two groups.Results The operation time and postoperative drainage tube indwelling time in group B were significantly lower than those in group A(P<0.05).The difference in intraoperative blood loss and hospitalization time between group A and group B was not statistically significant(P>0.05);The difference of AP values between group A and group B was not statistically significant(P>0.05);6 months after operation and 1 year after operation,the AP value of group B was lower than that of group A(P<0.05);Before and 1 year after operation,the difference of Scr and glomerular filtration rate between the two groups was not statistically significant(P>0.05);the Scr of 1 year after operation in both groups,the value was significantly lower than that before surgery(P<0.05),and the glomerular filtration rate was significantly higher than that before surgery(P<0.05).The surgical complication rate of group A was 16.7%compared with 6.4%of group B.The difference was not statistically significant(P>0.05).Conclusion Laparoscopic Anderson-Hynes combined with RIRS for the treatment of UPJO,compared with laparoscopic Anderson-Hynes surgery,can further shorten the operation time,reduce the indwelling time of the drainage tube,and further r

关 键 词：腹腔镜 Anderson-Hynes术式 逆行输尿管软镜手术 肾盂输尿管连接部梗阻 

分 类 号：R692[医药卫生—泌尿科学]