后腹腔镜输尿管切开取石术与输尿管镜碎石取石术对单侧输尿管上段结石的临床疗效对比

摘要

目的:分析后腹腔镜输尿管切开取石术与输尿管镜碎石取石术对单侧输尿管上段结石的临床治疗效果.方法:选择单侧输尿管上段结石患者160例,随机分为观察组与对照组各80例;对照组采用输尿管镜碎石取石术进行治疗,观察组采用后腹腔镜输尿管切开取石术进行治疗,比较两组术中出血量、手术时间以及住院时间、手术成功率、术后结石残留率和术后并发症发生率.结果:两组的术中出血量分别为(3.25±0.78)mL和(35.42±6.75)mL,手术时间分别为(42.15±9.78)min和(78.36±10.25)min,住院时间分别为(3.24±1.76)d和(6.83±2.15)d,两组数据相比差异均有统计学意义(P＜0.05);观察组手术成功率高于对照组(P＜0.05),术后结石残留率和术后并发症发生率低于对照组(P＜0.05).结论:输尿管镜碎石取石术具有术中出血量少、住院时间和手术时间短等优点,但手术成功率低、术后结石残留率和术后并发症高;后腹腔镜输尿管切开取石术具有高效、安全、创伤小、结石清除率高及并发症少的优点.%Objective:To analyze and compare the clinical effects of retroperitoneoscopic ureterolithotomy and ureteroscopic lithotripsy on unilateral upper ureteral calculi.Methods:160 cases of patients with unilateral upper ureteral calculi were randomly divided into observation group and control group,80 cases in each group.Patients in control group were treated with ureteroscopic lithotripsy,and those in observation group received retroperitoneoscopic ureterolithotomy.The blood loss,operation time,hospitalization time,operation success rate,residual rate of postoperative stones and incidence of postoperative complications were compared between the two groups.Results:The intraoperative blood losses in observation group and control group were (3.25±0.78)mL and (35.42±6.75)mL,the operative times were (42.15±9.78)min and (78.36±10.25)min,and the hospitalization times were (3.24±1.76)d and (6.83±2.15)d respectively.There were significant differences between the two groups (P＜0.05).The success rate of operation in observation group was higher than that in control group (P＜0.05).The residual rate of postoperative stones and incidence of postoperative complications in observation group were lower than those in control group (P＜0.05).Conclusion:Ureteroscopic lithotripsy,with the advantages of less blood loss during operation,shorter hospital stay and shorter operative time,has but yet low success rate of operation and high residual rate of postoperative stones and incidence of postoperative complications.Retroperitoneoscopic ureterolithotomy has the advantages of high efficiency,safety,less trauma,high rate of stone clearance and less complication.