目的：比较经后腹腔镜与输尿管镜治疗输尿管上段结石的临床疗效，探讨治疗体会。方法2012年4月-2013年11月入住该院泌尿科确诊为输尿管上段结石患者40例，随机分为后腹腔镜治疗组（n＝20）和输尿管镜治疗组（n＝20）。两组患者在性别、年龄、病程、结石大小等方面均无统计学差异（P＞0．05）。比较两组患者的手术时间、术中出血量、卧床时间、术后住院时间、结石清除率及手术并发症等情况。结果后腹腔镜组与输尿管镜组手术时间分别为（55．5±10．2）和（45．2±5．3） min，术中出血量分别为（80．0±25．4）和（3．5±0．5）mL，卧床时间分别为（1．8±1．2）和（1．0±0．5）d，住院时间分别为（5．5±1．7）和（2．5±1．4）d，差异有统计学意义（P&0．05）；后腹腔镜组与输尿管镜组手术成功率无显著性差异（100％ vs 100％， P＜0．05），后腹腔镜组结石清除率显著高于输尿管镜组（100％ vs 80．0％，P＜0．05），后腹腔镜组并发症发生率明显低于输尿管镜组（10．0％ vs 20．0％，P＜0．05）。结论后腹腔镜输尿管切开取石术治疗输尿管上段结石较输尿管镜碎石术疗效确切，结石清除率高，并发症发生少，是治疗输尿管结石的一种安全有效的方法。%Objective To compare the efficacies of retroperitoneal laparoscopic ureterolithotomy (RLU )and ureteroscopic lithotripsy (URL)for unilateral upper ureteral calculi,and to discuss the surgical skills of both treatments.Methods Forty cases of unilateral upper ureteral calculi admitted to The First Hospital of Anqing from April 201 2 to November 201 3 were randomly assigned into RLU group (n=20)and URL group (n=20).There were no significant differences between the two groups in terms of gender,age,dis-ease course,stone size and location(P>0.05).Data on the operation time,blood loss,postoperative bed time,postoperative hospitali-zation time,stone-free rate and complication incidence were compared between the two groups.Results In the RLU and URL groups, the operation time,the blood loss,the postoperative bed time,and the postoperative hospitalization time were(55.5 ±1 0.2)vs(45.2 ±5.3)min,(80.0 ±25.4)vs(3.5 ±0.5)mL,(1 .8 ±1 .2)vs(1 .0 ±0.5)d,and(5.5 ±1 .7)vs (2.5 ±1 .4)d,respectively.There were significant differences(P<0.05).The stone-free rate was 1 00%(20/20)in RLU group and 80.0%(1 6/20)in URL group.The complication incidence rate was 1 0.0%(2/20)in RLU group and 20.0%(4/20)in URL group.The differences were significant(P<0.05).Conclusions RLU has great advantages of high stone-free rate and less postoperative complications over URL when dealing with complicated upper ureteral calculi.
展开▼
