不同腔镜微创手术治疗复杂性输尿管结石的疗效差异研究  

Study on the difference of curative effect of different endoscopic minimally invasive surgery in the treatment of complex ureteral calculi

作　　者：徐佳栋 徐钱[1] 朱慧[1] 刘先艮[1] 谈树宾[1] Xu Jiadong;Xu Qian;Zhu Hui;Liu Xiangen;Tan Shubin(Department of Urology,the Third People's Hospital of Nantong City,Jiangsu Nantong 226000)

机构地区：[1]南通市第三人民医院泌尿外科,江苏南通226000

出　　处：《中国社区医师》2021年第6期72-73,共2页Chinese Community Doctors

摘　　要：目的:分析不同腔镜微创手术治疗复杂性输尿管结石的疗效。方法:2017年12月-2020年8月收治复杂性输尿管结石患者150例,随机分为三组,各50例。A组实施经尿道输尿管镜取石术(URL)治疗,B组实施微创经皮肾镜取石术(MPCNL)治疗,C组实施后腹腔镜切开输尿管取石术(RLU)治疗,比较三组临床效果。结果:A组手术时间、住院时间及术中出血量均明显低于B组、C组,差异有统计学意义(P<0.05);B组、C组一次性结石清除率明显高于A组,差异有统计学意义(P<0.05);C组并发症率发生率明显低于A组,且A组明显低于B组,差异均有统计学意义(P<0.05)。结论:治疗复杂性输尿管结石,URL操作简单方便,MPCNL与RLU一次性结石清除率比URL高,且RLU并发症发生率低,可以依据实际情况,合理选择术式。Objective:To explore the curative effect of different endoscopic minimally invasive surgery in the treatment of complex ureteral calculi.Methods:From December 2017 to August 2020,150 patients with complex ureteral calculi were selected and randomly divided into three groups with 50 patients in each group.Group A was treated with transurethral ureteroscopic lithotomy(URL).Group B was treated with minimally invasive percutaneous nephrolithotomy(MPCNL).Group C was treated with retroperitoneal laparoscopic ureterolithotomy(RLU).We compared the clinical effects of the three groups.Results:In group A,the operation time,hospital stay and intraoperative blood loss were significantly lower than those in group B and group C,the difference was statistically significant(P<0.05).In group B and group C,the stone clearance rate was significantly higher than that in group A,the difference was statistically significant(P<0.05).In group C,the incidence of complications was significantly lower than that in group A,and that in group A was significantly lower than that in group B,the difference was statistically significant(P<0.05).Conclusion:In the treatment of complex ureteral calculi,URL operation is simple and convenient,the one-time stone clearance rate of MPCNL and RLU is higher than that of URL,and the incidence of complications of RLU is low,we can reasonably choose the operation method according to the actual situation.

关 键 词：经尿道输尿管镜取石术 微创经皮肾镜取石术 后腹腔镜切开输尿管取石术 复杂性输尿管结石 疗效 

分 类 号：R699.4[医药卫生—泌尿科学]