微创经皮肾镜碎石与输尿管镜碎石术治疗嵌顿性输尿管上段结石的效果比较  

Comparison of the Effect of Minimally Invasive Percutaneous Nephrolithotomy and Ureteroscopic Lithotripsy in the Treatment of Incarcerated Upper Ureteral Calculi

作　　者：袁宝国[1] YUAN Bao-guo(Department of Urology,Yangzhou Friendship Hospital,Yangzhou University School of Medicine,Yangzhou,Jiangsu Province,225000 China)

机构地区：[1]扬州大学医学院附属扬州友好医院泌尿外科,江苏扬州225000

出　　处：《中外医疗》2020年第34期41-43,共3页China & Foreign Medical Treatment

摘　　要：目的比较分析嵌顿性输尿管上段结石患者应用微创经皮肾镜碎石术(MPCNL)与经输尿管镜碎石术(URL)治疗的临床效果。方法方便选取2018年2月—2020年2月在该院治疗的56例嵌顿性输尿管上段结石患者为研究对象,按照随机分组法分成两组,对照组27例,试验组29例。对照组应用URL治疗,试验组应用MPCNL治疗,对比两组手术时间、住院时间、结石清除率、中转开放手术率及并发症发生率。结果试验组手术时间、住院时间分别为(50.76±10.68)min、(5.06±1.13)d,明显短于对照组的(70.13±11.24)min、(7.74±1.32)d,差异有统计学意义(t=6.613、8.180,P<0.05)。试验组结石清除率、中转开放手术率分别为96.55%、0.00%,明显优于对照组的74.07%、22.22%,差异有统计学意义(χ^2=4.510、4.630,P<0.05)。试验组并发症发生率为6.90%,对照组为11.11%,差异无统计学意义(χ^2=0.007,P>0.05)。结论相较于URL治疗,MPCNL治疗嵌顿性输尿管上段结石的效果更加理想,不仅可以提高结石清除率,减少中转开放手术,还可以缩短手术时间与住院时间。Objective To compare and analyze the clinical effects of minimally invasive percutaneous nephrolithotomy(MPCNL)and transureteroscope lithotripsy(URL)in patients with incarcerated upper ureteral calculi.Methods A total of 56 patients with incarcerated upper ureteral calculi who were treated in the hospital from February 2018 to February 2020 were conveniently selected as the research objects.They were divided into two groups according to the random grouping method,with 27 cases in the control group and 29 cases in the experimental group.The control group was treated with URL,and the experimental group was treated with MPCNL.The operation time,hospital stay,stone removal rate,transfer to open surgery rate,and complication rate were compared between the two groups.Results The operation time and hospitalization time in the experimental group were(50.76±10.68)min and(5.06±1.13)days,which were significantly shorter than those in the control group(70.13±11.24)min and(7.74±1.32)days.The difference was statistically significant(t=6.613,8.180,P<0.05).The rate of stone removal and conversion to open surgery in the experimental group were 96.55%and 0.00%,which were significantly better than those in the control group,74.07%and 22.22%.There were statistical differences between the two groups,the difference was statistically significant(χ2=4.510,4.630,P<0.05).The complication rate was 6.90%in the experimental group and 11.11%in the control group.There was not statistical difference between the groups(χ2=0.007,P>0.05).Conclusion Compared with URL treatment,MPCNL is more effective in treating incarcerated upper ureteral calculi.It can not only improve the stone clearance rate,reduce the transfer to open surgery,but also shorten the operation time and hospital stay.It is worthy of clinical application and promotion.

关 键 词：嵌顿性输尿管上段结石 微创经皮肾镜碎石术 经输尿管镜碎石术 结石清除率 并发症 

分 类 号：R699[医药卫生—泌尿科学]