两种微创方法治疗第5腰椎下缘水平难治性输尿管结石疗效观察

摘要

目的 探讨治疗第5腰椎下缘水平难治性输尿管结石的最佳手术方法.方法 回顾性分析我院2003年7月-2010年5月收治的第5腰椎下缘水平难治性输尿管结石患者100例的临床资料,其中50例行输尿管镜碎石术(URL),50例行后腹腔镜输尿管切开取石术(RUL),术后对两种方法的临床疗效进行比较.结果 URL组一次碎石率为85.3%,RUL组一次碎石率为100.0%.其中10例行URL患者结石上移行经皮肾镜碎石术(PCNL)和体外冲击波碎石治疗.结论 RUL治疗第5腰椎下缘水平输尿管结石是一种微创且有效的方法,其结石清除率明显优于URL,并发症较少.%Objective To discuss the best surgical treatment method for ureteral stones at the lower edge of the fifth lumbar vertebra. Methods Retrospective analysis of the clinical data of 100 patients with refractory ureteral stones ( L5 level) in our hospital from July 2003 to May 2010 was carried out. Fifty cases were treated with ureteroscopic lithotripsy ( URL ) operation and 50 were treated with laparoscopic ureteral incision. Efficacy of both methods were compared after the operation. Results The rates of gravel were 85. 3% in the URL group and 100. 0% in the RUL group. After URL operation, the line of stones moved up in 10 cases and PCNL operation was applied to resolve the situation. Conclusion RUL treatment of refractory ureteral calculus at the lower edge of the fifth lumbar vertebra is both minimally invasive and effective. It displays superior clearance rate, residual rate and complication rate in comparison to URL.