经输尿管镜取石术在治疗复杂性输尿管上段结石中的临床研究

摘要

Objective:To compare and analyze clinical effects of ureteroscopic lithotripsy(URL)in the treatment of complicated ureteral calculi. Method:70 patients who had received treatments of URL in our hospital from January 2010 to January 2012 were chosen,the patients were randomly divided into experimental and control groups,35 people in each group. The experimental group received treatment of URL to remove stones,whereas the control group undergone treatment of extracorporeal shock wave lithotripsy(ESWL). 1 week and 4 weeks after the surgery,all patient were reviewed. Patients who were found with stones need to be rechecked until two months after the review. All patients were followed up for 2-10 months,with an average of six months. The treatment effects were evaluated based on the following standards:operation time,time of postoperative hospital stay,rate of successful surgery,the amount of bleeding,clearance rate of stones,complications,and other indicators.Result:After treatment,the successful rate of experimental group was significantly higher than that of the control group(P<0.05);the clearance rate of stones after 1 week of the treatment for the experimental and control groups were 68.9% and 34.5 % respectively,the clearance rate of stones after 1 month of the treatment for the experimental and control groups were 78.3% and 44.3% respectively,the differences between two groups were statistically significant(P<0.05);remaining indicators between two groups were not significantly different(P>0.05).Conclusion:URL is a feasible and effective method to treat complicated ureteral calculi.%　　目的：对比研究经输尿管镜取石术在治疗复杂性输尿管上段结石中的临床疗效。方法：选取2010年1月-2012年1月于本院接受治疗的复杂性输尿管上段结石患者70例，将70例患者随机分为实验组和对照组，每组35例，实验组患者接受经输尿管镜取石术（URL）清除结石，对照组患者接受体外冲击波碎石（ESWL）清除结石。手术后1周内和第4周内对患者进行复查，对术后4周仍发现结石的患者等待到术后2个月再次复查同样的项目。对所有患者进行随访，随访时间为2~10个月，平均6个月。对两组的手术时间、术后住院时间、一次手术成功率、出血量、结石清除率、并发症等指标进行评价。结果：治疗后实验组（URL）的一次手术成功率与对照组（ESWL）相比差异具有统计学意义（P<0.05）；术后1周结石清除率实验组和对照组分别为68.9%和34.5%，术后1个月结石清除率分别为78.3%和44.3%，两组相比差异具有统计学意义（P<0.05）；其余各项指标两组差异无统计学意义（P>0.05）。结论：综合考虑治疗复杂性输尿管上段结石使用 URL 方法的临床疗效更佳。