Less-RU治疗输尿管上段结石对的手术方法及临床相关分析  

The surgical method and clinical application of Less RU in the treatment of upper ureteral calculi

作　　者：李颖[1] 赵磊[1] 张洑源 陈旭东[1] Ying Li;Lei Zhao;Fuyuan Zhang;Xudong Chen(Department of Urology,Dandong Central Hospital,Dandong 118002,China)

机构地区：[1]丹东市中心医院泌尿外科,丹东118002

出　　处：《湖南师范大学学报（医学版）》2022年第5期76-79,共4页Journal of Hunan Normal University(Medical Sciences)

摘　　要：目的 :探讨输尿管上段结石患者应用单孔后腹腔镜输尿管切开取石术(Less-RU)治疗的临床应用价值。方法 :选取2016年4月~2017年8月我院采取手术方式治疗的100例确诊输尿管上段结石患者,对患者的手术方法过程及相关指标进行回顾性研究,其中50例采用Less-RU手术治疗(腹腔镜组)、50例患者采用微创经皮肾镜取石术(MPCNL组),统计分析患者的手术治疗所需要的时间、结石清除效果、手术结束后患者存在肉眼血尿及持续的时间、患者手术完成后开始下地活动时间、治疗过程的住院时间;对比两组患者术前、术后24h的血红蛋白(Hb)、血清可溶性血管细胞黏附分子-1(sVCAM-1)、血沉(ESR)及手术并发症。结果 :腹腔镜组患者的手术时间长于MPCNL组;腹腔镜组的术后肉眼血尿持续时间、术后下床活动时间、住院时间均短于MPCNL组且差异非常明显,两组患者的结石清除率对比差异并不明显;术前,腹腔镜组与MPCNL组的Hb、sVCAM-1、ESR测定值比较,基线水平比较无明显的差异性;术后24h,腹腔镜组患者的Hb测定值高于MPCNL组,腹腔镜组患者的sVCAM-1、ESR测定值均低于MPCNL组;腹腔镜组患者的手术并发症率2.00%低于MPCNL组的16.00%。结论 :输尿管上段结石患者采用Less-RU方法治疗较MPCNL手术时间更长,但是术后患者恢复更快、对患者Hb、sVCAM-1、ESR的影响更小、并发症率更低。Objective To investigate the clinical value of single-port retroperitoneal laparoscopic ureterotomy(Less-RU) in the treatment of upper ureteral calculi. Methods From April 2016 to August 2017, we selected 100 patients with upper ureteral calculi who were confirmed by surgery in our hospital. We retrospectively studied the surgical procedures and related indicators of the patients, 50 of whom were treated by Less RU surgery(laparoscopy group), 50 of whom were treated by minimally invasive percutaneous nephrolithotomy(MPCNL group), Statistically analyze the time required for surgical treatment of patients,the effect of stone removal, the time of gross hematuria and its duration after the operation, the time of starting to go down to the ground after the operation, and the hospital stay during the treatment process;Hemoglobin(Hb), serum soluble vascular cell adhesion molecule-1(sVCAM-1), erythrocyte sedimentation rate(ESR) and surgical complications were compared between the two groups before and 24 hours after operation. Results The operation time of laparoscopic group was longer than that of MPCNL group, with a significant difference;The duration of gross hematuria, the time of getting out of bed and hospitalization in laparoscopic group were significantly shorter than those in MPCNL group, and there was no significant difference in the stone clearance rate between the two groups;Before operation, there was no significant difference in Hb, sVCAM-1 and ESR between laparoscopic group and MPCNL group at baseline;At 24 hours after operation, the Hb values in the laparoscopic group were higher than those in the MPCNL group, and the sVCAM-1 and ESR values in the laparoscopic group were lower than those in the MPCNL group;The operative complication rate of laparoscopic group was 2.00%, which was lower than that of MPCNL group 16.00%. Conclusion The operation time of Less-RU for upper ureteral calculi is longer than that of MPCNL, but the postoperative recovery of patients is faster, the effect on Hb, sVCAM-1 and ESR is s

关 键 词：输尿管结石 单孔腹腔镜 输尿管切开取石 微创手术 经皮肾镜取石术 

分 类 号：R693[医药卫生—泌尿科学]