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目的比较迷你经皮肾镜碎石取石术和后腹腔镜下输尿管切开取石术对输尿管上段结石的疗效。方法选取我院2013年6月至2016年6月因输尿管上段嵌顿性结石手术患者128例,其中63例行经迷你皮肾镜碎石取石术,65例行经后腹腔镜下输尿管切开取石术。比较两组患者手术前后情况,包括结石大小、体质指数、手术时间、出血量、术后疼痛评分、术后住院时间,术后随访6个月(有8例术后失访),比较术后结石取净率、并发症发生率及症状缓解率等。结果 120例患者手术皆获得成功,两组在手术时间、术中出血量、术后疼痛、术后住院时间及并发症等方面的比较差异有统计学意义,术前结石大小、结石取净率、术后症状缓解率等比较无统计学意义。结论两种手术方式对输尿管上段嵌顿性结石均取得良好的治疗效果,但后腹腔镜下输尿管切开取石术在术中出血、术后疼痛、缩短术后住院时间及降低术后并发症的发生方面更有优势。
Objective To compare the effects of mini percutaneous nephrolithotomy and laparoscopic ureterolithotomy on the upper ureteral calculi. Methods From June 2013 to June 2016, 128 patients with upper ureteral incarcerated stone surgery were selected, of whom 63 underwent mini-lithotripsy and 65 underwent laparoscopic ureterotomy Stone surgery. Comparisons were made between the two groups before and after surgery, including stone size, body mass index, operation time, bleeding volume, postoperative pain score, postoperative hospital stay, postoperative follow-up of 6 months (8 postoperative follow-up) Stone take rate, complication rate and symptom relief rate. Results All the 120 patients were successful in operation. There was significant difference between the two groups in operation time, intraoperative blood loss, postoperative pain, postoperative hospital stay and complications. The preoperative stone size, stone removal rate , Postoperative symptom relief rate was no statistical significance. Conclusion Both methods of operation have good curative effect on incarcerated ureteral calculi. However, retroperitoneal laparoscopic ureterolithotomy has the advantages of intraoperative bleeding, postoperative pain, shortened postoperative hospital stay and postoperative complications More advantages occur.