后腹腔镜下输尿管切开取石术与输尿管镜碎石术 治疗嵌顿性输尿管上段结石合并感染的临床疗效  

Clinical efficacy of retroperitoneal laparoscopic ureterolithotomy and ureteroscopy lithotripsy on incarcerated upper ureteral calculi combined with infection

作　　者：吴军 郑萍 余凯烨 WU Jun;ZHENG Ping;YU Kaiye(Department of urology,Shangrao Municipal Hospital,Shangrao,Jiangxi,334000,China)

机构地区：[1]江西省上饶市立医院泌尿外科,江西上饶334000

出　　处：《当代医学》2022年第29期123-126,共4页Contemporary Medicine

摘　　要：目的探讨后腹腔镜下输尿管切开取石术(RLU)和输尿管镜碎石术(URL)治疗嵌顿性输尿管上段结石合并感染的临床疗效。方法选取2019年1月至2021年1月本院收治的66例嵌顿性输尿管上段结石合并感染的患者作为研究对象,采用简单随机分组法分为对照组和观察组,每组33例。对照组采用RLU治疗,观察组采用URL治疗,比较两组手术情况、手术成功率、结石清除率、炎症因子[降钙素原(PCT)、白细胞介素-6(IL-6)、C-反应蛋白(CRP)、白细胞计数(WBC)]水平及并发症发生情况。结果两组住院时间比较差异无统计学意义,观察组手术时间短于对照组,出血量少于对照组,数字等级评价量表(NRS)评分低于对照组(P<0.05);观察组碎石成功率,术后7、30 d结石清除率均高于对照组(P<0.05);术后7 d,两组PCT、IL-6、CRP、WBC水平均低于治疗前,且观察组PCT、CRP、WBC低于对照组(P<0.05);观察组并发症发生率明显低于对照组(P<0.05)。结论URL治疗嵌顿性输尿管上段结石合并感染效果显著,可提高结石清除率,降低并发症的发生率,其效果优于RLU,应用于临床更加安全,值得临床推广应用。Objective To explore the clinical efficacy of retroperitoneal laparoscopic ureterolithotomy(RLU)and ureteroscopy lithotripsy(URL)in the treatment of incarcerated upper ureteral calculi combined with infection.Methods 66 patients with incarcerated upper ureteral calculi complicated with infection admitted to our hospital from January 2019 to January 2021 were selected as research subjects,and they were divided into control group and observation group by simple randomization method,with 33 cases in each group.The control group was treated with RLU,while observation group was treated with URL.The operation status,operation success rate,stone clearance rate,levels of inflammatory factors(procalcitonin[PCT],interleukin-6[IL-6],C-reactive protein[CRP],white blood cell count[WBC])and the incidence of complications were compared between the two groups.Results There was no significant difference in hospitalization time between the two groups.The operation time in observation group was shorter than that in control group,blood loss was less than that in control group,and score of numerical rating scale(NRS)was lower than that in control group(P<0.05).The success rate of lithotripsy and the stone clearance rates at 7 d and 30 d after surgery in observation group were higher than those in control group(P<0.05).At 7d after surgery,levels of PCT,IL-6,CRP and WBC in both groups were decreased.The levels of PCT,CRP and WBC in observation group were lower than those in control group(P<0.05).The incidence of complications in observation group was significantly lower than that in control group(P<0.05).Conclusion URL has a significant effect on the treatment of incarcerated upper ureteral calculi complicated with infection,can improve the stone clearance rate,reduce the incidence of complications,its effect is better than RLU,higher safety,worthy of clinical application.

关 键 词：后腹腔镜下输尿管切开取石术 输尿管镜碎石术治疗 嵌顿性输尿管上段结石 感染 疗效 安全性 

分 类 号：R699.4[医药卫生—泌尿科学]