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目的:探讨经尿道输尿管镜激光取石术、经皮肾穿刺取石术及后腹腔镜切开取石术治疗复杂性输尿管上段结石临床疗效、安全性及经济性差异。方法:研究对象选取2012年6月~2015年6月收治复杂性输尿管上段结石患者共150例,采用随机区组法分为A组(50例)、B组(50例)及C组(50例),分别行经尿道输尿管镜激光取石术、经皮肾穿刺取石术及后腹腔镜切开取石术治疗;比较三组患者围手术期临床指标、一次性结石清除率、术后并发症发生率及总治疗费用等。结果:C组患者手术时间均显著长于A、B组,差异有统计学意义(P<0.05);B组患者术中出血量均显著多于A、C组,差异有统计学意义(P<0.05);B组和C组患者一次性结石清除率显著高于A组,差异有统计学意义(P<0.05);C组患者术后并发症发生率显著低于A、B组,差异有统计学意义(P<0.05);C组患者总治疗费用显著低于A、B组,差异有统计学意义(P<0.05)。结论:后腹腔镜切开取石术治疗复杂性输尿管上段结石可显著提高结石清除效果,降低术后并发症发生率,并有助于减少治疗费用,临床价值优于经尿道输尿管镜激光取石术和经皮肾穿刺取石术。
Objective: To investigate the clinical efficacy, safety and economic difference of transurethral ureteroscopic laser lithotripsy, percutaneous nephrolithotomy and retroperitoneal laparoscopic lithotripsy in the treatment of complex upper ureteral calculi. Methods: A total of 150 patients with complicated ureteral calculi in our hospital from June 2012 to June 2015 were selected and randomly divided into group A (50 cases), group B (50 cases) and group C (50 cases) Cases) were treated by transurethral ureteroscopic lithotripsy, percutaneous nephrolithotomy and retroperitoneal laparoscopic lithotripsy. The perioperative clinical indexes, the rate of primary stone removal, the incidence of postoperative complications And the total treatment costs. Results: The operation time of group C was significantly longer than that of group A and B (P <0.05). The bleeding volume of group B was significantly higher than that of group A and C (P < 0.05). The rate of stone removal in group B and C was significantly higher than that in group A (P <0.05). The incidence of postoperative complications in group C was significantly lower than that in group A and B (P <0.05). The total cost of treatment in group C was significantly lower than that in group A and B (P <0.05). Conclusions: Retroperitoneoscopic laparoscopic stone removal in the treatment of complex upper ureteral calculi can significantly improve the stone removal, reduce the incidence of postoperative complications, and help to reduce the cost of treatment, the clinical value is superior to transurethral ureteroscopic laser lithotripsy and Percutaneous nephrolithotomy.