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目的比较微创经皮肾镜(m PCNL)与后腹腔镜(RLU)手术治疗输尿管上段结石的临床疗效。方法回顾性分析69例输尿管上段结石患者的临床资料。其中采用m PCNL治疗33例(A组),采用RLU治疗36例(B组),比较两组的手术时间、住院时间、手术成功率、结石清除率及并发症发生率。结果 A组手术时间明显短于B组[(38.8±5.2)min vs(60.5±8.5)min,P<0.05],差异有统计学意义。两组的术后住院时间、手术成功率、结石清除率及手术并发症发生率分别为(6.6±1.1)d vs(6.2±1.3)d、96.96%vs 94.44%、100%vs 100%、6.25%vs5.88%,差异均无统计学意义(P>0.05)。两组均未出现大出血病例。结论 m PCNL和RLU均是治疗输尿管上段结石安全可靠、疗效肯定的手术方式,应根据具体情况及患者意愿制定出个体化治疗方案,以达降低损伤、减少并发症、提高清石率的治疗目的。
Objective To compare the clinical efficacy of minimally invasive percutaneous nephrolithotomy (m PCNL) and retroperitoneal laparoscopy (RLU) in the treatment of upper ureteral calculi. Methods A retrospective analysis of 69 cases of upper ureteral calculi in patients with clinical data. Among them, 33 patients were treated with m PCNL (group A) and 36 patients were treated with RLU (group B). The operation time, hospitalization time, operation success rate, stone clearance rate and complication rate were compared between the two groups. Results The operation time of group A was significantly shorter than that of group B [(38.8 ± 5.2) min vs (60.5 ± 8.5) min, P <0.05]. The difference was statistically significant. The postoperative hospital stay, operative success rate, stone clearance rate and operative complication rates in the two groups were (6.6 ± 1.1) d vs (6.2 ± 1.3) d, 96.96% vs 94.44%, 100% vs 100%, 6.25 % vs5.88%, the difference was not statistically significant (P> 0.05). No major bleeding in both groups. Conclusion m PCNL and RLU are both safe and reliable surgical treatment of upper ureteral calculi. Individualized treatment plans should be worked out according to the specific conditions and patients’ wishes so as to reduce the injury, reduce the complications and improve the therapeutic rate of clear stone. .