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目的:探讨输尿管上段结石并重度肾积水的治疗方法。方法:回顾性分析佛冈县人民医院2012年7月至2017年1月收治的输尿管上段结石并重度肾积液患者75例临床资料,采用腹膜后入路腹腔镜输尿管切开取石术(RLU)或经皮肾镜碎石取石术(PCNL)治疗,统计手术时间、住院天数、住院费用、结石清除率、手术并发症等资料。结果:两组患者均手术成功,PCNL 31例,RLU 44例,在手术时间、结石清除率、住院费用等方面腹腔镜手术组优于经皮肾镜手术组,差异具有统计学意义(P<0.05),两组患者住院天数、手术并发症比较,差异均无统计学意义(P>0.05)。结论:对于输尿管结石并重度肾积水的患者,腹腔镜与经皮肾镜技术均安全、有效,腹腔镜输尿管切开取石术有一定的优势,可作为首选的治疗方法。
Objective: To investigate the treatment of upper ureteral calculi and severe hydronephrosis. Methods: The clinical data of 75 patients with upper ureteral calculi and severe hydronephrosis admitted to Fagang People’s Hospital from July 2012 to January 2017 were analyzed retrospectively. The retroperitoneal laparoscopic ureteral calculi (RLU) Or percutaneous nephrolithotomy (PCNL) treatment, statistics of operation time, hospitalization days, hospitalization costs, stone clearance, surgical complications and other data. Results: In both groups, 31 cases were successful in operation, including 31 cases of PCNL and 44 cases of RLU. Laparoscopic surgery group was superior to percutaneous nephrolithotomy group in operation time, stone clearance rate and hospitalization expense, the difference was statistically significant (P < 0.05). There was no significant difference between the two groups in hospitalization days and complication of surgery (P> 0.05). Conclusion: For patients with ureteral calculi and severe hydronephrosis, laparoscopic and percutaneous nephrolithotomy are safe and effective. Laparoscopic ureterolithotomy has some advantages and can be used as the first choice of treatment.