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目的比较输尿管软镜与微创经皮肾镜治疗输尿管上段结石的效果。方法选取2012年3月—2015年2月成都军区总医院收治的输尿管上段结石患者100例,随机分为研究组(接受微创经皮肾镜治疗)和对照组(接受输尿管软镜治疗),各50例。比较两组患者肾积水程度、结石大小、手术时间、住院费用、手术并发症、术后4个月无石率。结果两组患者肾积水程度、结石大小及输尿管狭窄和漏尿发生率比较,差异无统计学意义(P>0.05)。研究组手术时间短于对照组、住院费用少于对照组,差异有统计学意义(P<0.05)。对照组迟发出血发生率高于研究组,差异有统计学意义(P<0.05)。研究组4个月无石率为28.0%,高于对照组的12.0%,差异有统计学意义(P<0.05)。结论微创经皮肾镜较输尿管软镜治疗输尿管上段结石的手术时间短、费用低,术后并发症少。
Objective To compare the effect of ureteroscopic and minimally invasive percutaneous nephrolithotomy in the treatment of upper ureteral calculi. Methods A total of 100 patients with upper ureteral calculi admitted to Chengdu General Hospital of Military Region from March 2012 to February 2015 were randomly divided into study group (receiving minimally invasive percutaneous nephrolithotomy) and control group (receiving ureteroscopic treatment) 50 cases each. The degree of hydronephrosis, the size of stone, the operation time, the cost of hospitalization and the complication of surgery were compared between the two groups. No stone rate was found after 4 months. Results There was no significant difference in hydronephrosis degree, stone size, ureteral stricture and leakage of urine between the two groups (P> 0.05). The operation time of the study group was shorter than that of the control group, and the hospitalization expense was less than that of the control group (P <0.05). The incidence of delayed bleeding in the control group was higher than that in the study group, with significant difference (P <0.05). The stoneless rate of the study group at 4 months was 28.0%, which was higher than that of the control group (12.0%), the difference was statistically significant (P <0.05). Conclusion The minimally invasive percutaneous nephrolithotomy has shorter operative time, lower cost and fewer postoperative complications than the ureteroscopic treatment of upper ureteral calculi.