无管化微通道经皮肾镜取石术治疗嵌顿性输尿管上段结石的临床效果分析

摘要

Objective:To analyze the clinical effect of non tube micro-channel of percutaneous nephro-lithotomy treatment of impacted upper ureteral calculi and provide a scientific basis for improving clinical ef-ficacy of clinical impacted upper ureteral calculi.Methods:142 cases impacted proximal urethral calculi trea-ted in a hospital from January 2013 to December 2014 were randomly divided into observation group and con-trol group,7 1 cases in each group.The control group treated with laparoscopic ureteral stone surgery and the observation group treated with microchannel tubes percutaneous nephrolithotomy surgery.The operative time,blood loss,hospital stay,hematuria time,the incidence of complications and stone clearance rate of the two groups were compared.Results:Operation time of the observation group and control group was (97.5 ±31.8)min and (198.6±75.8)min respectively,blood loss was (28.4±19.7)mL and (75.8±89.5)mL, hospital stay was (6.4±1.6)days (11.8±3.6)days,hematuria time was (6.4±1.6)days (11.8±3.6)days, the complication rate was 7.0% (5/71)and 16.9% (12/71).The operation time,aspects of blood loss,hos-pital stay,hematuria time,complications rate of the observation group were significantly better than those of the control group (P<0.05),but the difference in stone-free rate was not statistically significant.Conclu-sion:Both the two kinds of surgery have a better clinical efficacy,but non-tube micro-channel percutaneous nephrolithotomy surgery has advantages of shorter operative time and less postoperative complications,wor-thy of clinical promotion.%目的：：分析无管化微通道经皮肾镜取石术治疗嵌顿性输尿管上段结石的临床效果，为提高临床嵌顿性输尿管上段结石的临床疗效提供科学依据。方法：选取2013年1月~2014年12月惠州市第一人民医院收诊嵌顿性输尿管上段结石142例患者，随机分为观察组与对照组，每组71例。对照组采取后腹腔镜下输尿管取石术，观察组使用无管化微通道经皮肾镜取石术。观察两组患者的手术时间、术中出血量、住院时间、血尿时间、并发症发生率以及结石清除率。结果：观察组与对照组的手术时间为(97.5±31.8) min和(198.6±75.8)min、术中出血量为(28.4±19.7)mL和(75.8±89.5)mL、住院时间为(6.4±1.6)d 和(11.8±3.6)d、血尿时间为(6.4±1.6)d和(11.8±3.6)d、并发症发生率为7.0%(5/71)和16.9%(12/71)，观察组在手术时间、术中出血量、住院时间、血尿时间、并发症发生率等方面都显著优于对照组(P<0.05)，但在结石清除率方面的比较差异无统计学意义。结论：两种手术都具有较好的临床疗效，但无管化微通道经皮肾镜取石术具有手术时间短、术后并发症少等优势，值得在临床中推广使用。