三种不同取石术治疗输尿管上段复杂性结石的效果与安全性  

Efficacy and Safety of Three Different Lithotripsy in the Treatment of Complex Upper Ureteral Calculus

作　　者：卢依刚[1] 张文圣[1] 万滨[1] LU Yigang;ZHANG Wensheng;WAN Bin(Jiujiang NO.1 People's Hospital,Jiangxi Province,Jiujiang 332000,China)

机构地区：[1]江西省九江市第一人民医院,江西九江332000

出　　处：《中国医学创新》2023年第11期31-34,共4页Medical Innovation of China

摘　　要：目的:比较输尿管镜碎石术(URL)、硕通镜碎石术(NPUR)、微通道经皮肾镜碎石术(MPCNL)在输尿管上段复杂性结石中的治疗效果与安全性。方法:选择2020年1月-2021年1月九江市第一人民医院收治的210例输尿管上段复杂性结石患者作为研究对象,采用随机数字表法分为A组(n=70)、B组(n=70)、C组(n=70)。A组接受URL治疗,B组接受NPUR治疗,C组接受MPCNL治疗。比较三组一般手术指标、手术成功率、结石清除率及术后1年内结石复发率。结果:C组手术持续时间短于A组、B组,差异均有统计学意义(P<0.05);三组术中出血量、住院时间比较,差异均无统计学意义(P>0.05);三组并发症发生率比较,差异无统计学意义(P>0.05)。C组手术成功率、结石清除率均高于A组、B组,差异均有统计学意义(P<0.05)。三组术后1年内结石复发率比较,差异无统计学意义(P>0.05)。结论:URL、NPUR及MPCNL在输尿管上段复杂性结石患者的应用中,以MPCNL的手术成功率最高,结石清除效果最好,同时具有手术时间短的优势,值得临床推广。Objective:To compare the efficacy and safety of ureteroscopic lithotripsy(URL),negative pressure combined with ureteroscopy(NPUR)and minimally percutaneous nephrolithotomy(MPCNL)in the treatment of complex upper ureteral calculus.Method:A total of 210 patients with complex upper ureteral calculus who were admitted to Jiujiang NO.1 People's Hospital from January 2020 to January 2021 were selected as the research subjects and divided into group A(n=70),group B(n=70)and group C(n=70)according to the random number table method.Group A received URL therapy,group B received NPUR therapy,and group C received MPCNL therapy.The general surgical indexes,the success rate of operation,the stone clearance rate and the recurrence rate of stones within one year after operation were compared among the three groups.Result:The duration of operation in group C was shorter than those in group A and B,the differences were statistically significant(P<0.05).There were no significant differences in intraoperative bleeding volume and hospitalization time among the three groups(P>0.05).There was no significant difference in the incidence of complications among the three groups(P>0.05).The success rate of operation and stone clearance rate in group C were higher than those in group A and B,the differences were statistically significant(P<0.05).There was no significant difference in recurrence rate of stones within one year after operation among the three groups(P>0.05).Conclusion:Among the applications of URL,NPUR and MPCNL for patients with complex upper ureteral calculus,MPCNL has the highest success rate of operation and the best effect of stone clearance,meanwhile,it has the advantage of short operation time,which is worthy of clinical promotion.

关 键 词：输尿管上段复杂性结石 输尿管镜碎石术 硕通镜碎石术 微通道经皮肾镜碎石术 结石清除率 

分 类 号：R699.4[医药卫生—泌尿科学]