经后腹腔镜与微通道经皮肾镜手术治疗复杂性输尿管上段结石的对比研究  

A comparative study of retroperitoneal laparoscopic and microchannel percutaneous nephrolithotomy for upper ureteral calculi

作　　者：晏恒馨 钟传华 张志洪 娄世洪 刘振 Yan Hengxin;Zhong Chuanhua;Zhang Zhihong(The Bozhou District People's Hospital of Zunyi City,Zunyi,Guizhou 563100)

机构地区：[1]遵义市播州区人民医院,贵州遵义563100

出　　处：《基层医学论坛》2021年第28期4005-4007,共3页The Medical Forum

基　　金：遵义市科技计划项目,联合资金项目(遵市科合HZ字(2019)245号)。

摘　　要：目的对比经后腹腔镜切开取石术(RLUL)与微通道经皮肾镜碎石取石术(MPCNL)治疗复杂性输尿管上段结石的临床疗效。方法选择遵义市播州区人民医院泌尿外科2016年1月-2021年3月期间收治的复杂性输尿管上段结石患者124例,按照患者意愿分为MPCNL组与RLUL组。对比评估2组的手术时间、术后卧床时间、术后拔除导尿管时间、术后住院天数,术后大出血、术后发热发生率、术后结石清除率,手术费用等。结果RLUL组术后发热率低于MPCNL组且结石清除率高于MPCNL组(P<0.05),2组术后大出血发生率无明显差异(P>0.05)。2组术后住院天数无明显差异(P>0.05),但MPCNL组手术时间低于RLUL组(P<0.05)。RLUL组术后卧床时间、术后拔除尿管时间、住院费用低于MPCNL组(P<0.05)。结论RLUL与MPCNL治疗,复杂性输尿管上段结石均具有微创疗效,但RLUL术后患者留置导尿管及卧床时间均较短,术后恢复快,结石清除率高,感染发热的概率低、相对安全,总治疗费用较低,同时运用的设备相对简单,更适合在基层医院推广。Objective To investigate the clinical efficacy of retroperitoneal laparoscopic lithotomy and microchannel percutaneous nephrolithotomy in the treatment of upper ureteral calculi,and to provide reference for the diagnosis and treatment of complex upper ureteral calculi and the reasonable selection of surgical methods in clinical practice.Methods A total of 124 inpatients with complicated upper segment ureteral calculi admitted to the Department of Urology of our hospital from January 2016 to March 2021 were selected and randomly divided into MPCNL group and RLUL group according to the surgical method and the wishes of their families.The operative time,postoperative bed rest,postoperative catheter withdrawal time,postoperative hospital stay,postoperative massive bleeding,postoperative fever,postoperative stone clearance rate,and surgical costs of the two groups were compared and evaluated.Results The fever rate of the RLUL group was much lower than that of the MPCNL group,and the stone clearance rate was much higher than that of the MPCNL group(P<0.05).There was no significant difference in the incidence of postoperative massive hemorrhage between the two groups(P BBB 00.05).There was no significant difference in postoperative hospital stay between the two groups(P BBB 00.05),but the operation time of MPCNL group was lower than that of RLUL group(P<0.05),and the postoperative bed rest time,postoperative catheter removal time and hospitalization cost of RLUL group were much lower than those of MPCNL group(P<0.05).Conclusion RLUL with MPCNL group treatment on the segment ureteral calculi with minimally invasive effect,after the laparoscope ureter incision to take stone,postoperative and stay in bed for a short time for detaining urethral catheter for patients,postoperative recovery fast,stone clearance rate is high,low risk of infection with fever,relative safety,lower total cost of treatment,at the same time,using the advantages of equipment is relatively simple,It is more suitable for popularization and development

关 键 词：复杂性输尿管上段结石 RLUL MPCNL 疗效对比 

分 类 号：R4[医药卫生—临床医学]