腹腔镜输尿管切开取石术与输尿管软镜钬激光碎石术治疗输尿管上段嵌顿性结石疗效比较  

Comparison of the therapeutic effect of laparoscopic ureterolithotomy and flexible ureteroscopy lithotripsy in the treatment of incarcerated upper ureteral calculi

作　　者：李龚龙[1] 葛玉坤 郝玉民 乔庆东[1] 王子琦 LI Gonglong;GE Yukun;HAO Yumin;QIAO Qingdong;WANG Ziqi(Department of the First Urologic Surgery,Xinxiang Central Hospital,Xinxiang 453000,Henan Province,China;Department of Urologic Surgery,Harbin Medical University Cancer Hospital,Harbin 150081,Heilongjiang Province,China)

机构地区：[1]新乡市中心医院泌尿外一科,河南新乡453000 [2]哈尔滨医科大学附属肿瘤医院泌尿外科,黑龙江哈尔滨150081

出　　处：《新乡医学院学报》2023年第6期538-542,共5页Journal of Xinxiang Medical University

基　　金：国家自然科学基金资助项目(编号:82171999)。

摘　　要：目的 比较腹腔镜输尿管切开取石术(LU)和输尿管软镜碎石取石术(FURL)治疗输尿管上段嵌顿性结石的临床效果。方法 选择2020年1月至2021年9月新乡市中心医院收治的57例结石处输尿管壁最大厚度(UWTmax)≥3.41 mm的单侧输尿管上段嵌顿性结石患者为研究对象,按手术方案将患者分为LU组(n=23)和FURL组(n=34)。比较2组患者的手术时间、术后住院时间、血红蛋白下降值、结石清除率和并发症发生率。结果 FURL组患者的手术时间、术后住院时间显著短于LU组(P<0.05);2组患者的血红蛋白下降值比较差异无统计学意义(P>0.05)。LU组和FURL组患者的结石清除率分别为100.00%(23/23)和73.53%(25/34),FURL组患者的结石清除率显著低于LU组(χ^(2)=5.376,P<0.05)。LU组和FURL组患者并发症发生率分别为13.04%(3/23)、8.82%(3/34),2组患者并发症发生率比较差异无统计学意义(χ^(2)=0.000,P>0.05)。结论 LU治疗结石处UWTmax≥3.41 mm的输尿管上段嵌顿性结石的结石清除率高于FURL,但FURL手术时间短、术后恢复快,临床应根据实际情况选择适合的治疗方法。Objective To compare the therapeutic effect of laparoscopic ureterolithotomy(LU)and flexible ureteroscopy lithotripsy(FURL)in the treatment of incarcerated upper ureteral calculi.Methods A total of 57 patients with incarcerated upper ureteral calculi with maximum ureteral wall thickness(UWTmax)≥3.41 mm admitted to the Xinxiang Central Hospital from January 2020 to September 2021 were selected as the research subjects.The patients were divided into LU group(n=23)and FURL group(n=34)according to surgical procedures.The operation time,postoperative hospital stay,hemoglobin reduction value,stone clearance rate and incidence of complications were compared between the two groups.Results The operation time and postoperative hospital stay of patients in the FURL group were significantly shorter than those in the LU group(P<0.05).There was no significant difference in hemoglobin reduction value of patients between the two groups(P>0.05).The stone clearance rate of patients in the LU group and FURL group was 100.00%(23/23)and 73.53%(25/34),respectively;the stone clearance rate of patients in the FURL group was significantly lower than that in the LU group(χ^(2)=5.376,P<0.05).The incidence of complications of patients in the LU group and FURL group was 13.04%(3/23)and 8.82%(3/34),respectively;there was no significant difference in the incidence of complications between the two groups(χ^(2)=0.000,P>0.05).Conclusion The stone clearance rate of LU in the treatment of incarcerated upper ureteral calculi with UWTmax≥3.41 mm is higher than FURL,but the FURL has shorter operation time and faster postoperative recovery.The proper therapeutic methods should be selected according to the practical situation.

关 键 词：输尿管结石 嵌顿 输尿管壁 腹腔镜 输尿管软镜 

分 类 号：R699.4[医药卫生—泌尿科学]