微通道经皮肾镜与输尿管软镜治疗嵌顿性输尿管上段结石疗效分析  

Curative effect of microchannel percutaneous nephrolithotomy and flexible ureteroscopy in the treatment of incarcerated upper ureteral calculi

作　　者：王钧平 乔助民 纪萌[2] 唐昊 吴金生[2] WANG Junping;QIAO Zhumin;JI Meng;TANG Hao;WU Jinsheng(Department of Surgery,Weifang Medical University,Weifang 261053,China;Department of Urology Surgery,the Affiliated Hospital of Weifang Medical University)

机构地区：[1]潍坊医学院外科学教研室,山东潍坊261053 [2]潍坊医学院附属医院泌尿外科

出　　处：《潍坊医学院学报》2020年第5期366-368,共3页Acta Academiae Medicinae Weifang

摘　　要：目的通过对比研究微通道经皮肾镜与输尿管软镜治疗嵌顿性输尿管上段结石疗效,为临床治疗该型结石提供最佳诊疗方案。方法回顾性分析我院泌尿外科2017年1月~2019年12月期间收治的176例单侧嵌顿性输尿管上段结石患者的临床资料,根据结石治疗方式将其分为经皮肾镜组92例及输尿管软镜组84例。对比分析两组手术时间、术中出血量、术后平均住院时间,一期结石清除率,手术并发症发生率并观察两组患者术后肾功能及肾积水改善情况。结果输尿管软镜组术中出血量少于经皮肾镜组,术后平均住院时间短于经皮肾镜组,但手术时间明显较经皮肾镜组长,差异有显著性(P<0.05);两组一期结石清除率差异无显著性(P>0.05);术后并发症发生率差异无显著性(P>0.05);两组患者术后肾功能及肾积水改善情况比较,差异无显著性(P>0.05)。结论对于嵌顿性输尿管上段结石,经皮肾镜碎石取石术在手术时间方面有明显优势,输尿管软镜在术后平均住院时间、术中出血量等方面有明显优势,两种治疗方式均是有效的治疗方式,临床应根据实际情况合理选择。Objective The effect of microchannel percutaneous nephrolithotomy and flexible ureteroscopy in the treatment of incarcerated upper ureteral calculi was compared to provide the best clinical treatment plan for this type of calculi.Methods Retrospective analysis was performed in 176 cases of upper ureteral calculi treated with PCNL or FURL in our hospital between January 2017 to December 2019,the one group was treated with percutaneous nephrolithotomy(92 cases),while the other group was treated with flexible ureteroscope lithotripsy(84 cases).The operation time,intraoperative blood loss,average postoperative hospital stay,stone clearance rate,renal function indexes,and complication rate were compared between the two groups.Results The operative blood loss in the ureteroscope group was less than that in the percutaneous nephroscopy group,and the average postoperative hospital stay was shorter than that in the percutaneous nephrolithotomy group(P<0.05),but the operation time was significantly longer than that in the percutaneous nephrolithotomy group.There was no significant difference in the stone clearance rate between the two groups(P>0.05).There was no statistically significant difference in the incidence of postoperative complications(P>0.05).There was no statistically significant difference between the two groups in the improvement of postoperative renal function and hydronephrosis(P>0.05).Conclusions For incarcerated upper ureteral calculi,percutaneous nephrolithotomy has obvious advantages in terms of operation time,while ureteroscope has obvious advantages in terms of average postoperative hospital stay and intraoperative blood loss,etc.Both of the two treatment methods are effective,which should be selected reasonably according to the actual situation.

关 键 词：嵌顿性输尿管上段结石 经皮肾镜 输尿管软镜 疗效分析 

分 类 号：R693.4[医药卫生—泌尿科学]