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目的探讨比较经皮肾镜碎石取石术(PCNL)与后腹腔镜输尿管切开取石术(RLU)治疗输尿管上段嵌顿性结石疗效。方法 102例输尿管上段嵌顿性结石患者按手术方式分为PCNL组(54例)和RLU组(48例)。比较两组结石清除率、手术情况及并发症发生情况。结果术后1周,PCNL组和RLU组结石清除率分别为96.3%和93.7%,组间比较差异无统计学意义(P>0.05);与RLU组相比,PCNL组手术时间及住院时间缩短,术中出血量增多(P<0.05)。术中及术后,两组均未发生严重并发症。结论 PCNL和RLU均是治疗输尿管上段嵌顿性结石的有效手术方法 ,结石清除率及安全性高,但PCNL手术时间、住院时间短,在术后康复方面具有明显优越性,值得临床进一步推广。
Objective To compare the efficacy of percutaneous nephrolithotomy (PCNL) and retroperitoneal ureterolithotomy (RLU) in the treatment of incarcerated upper ureteral calculi. Methods One hundred and two cases of upper ureteral incarcerated stone were divided into PCNL group (54 cases) and RLU group (48 cases) by operation method. The stone clearance rate, operation condition and complication of the two groups were compared. Results The stone clearance rate in PCNL group and RLU group was 96.3% and 93.7% respectively at 1 week after operation, showing no significant difference between the two groups (P> 0.05). Compared with RLU group, the operation time and hospitalization time in PCNL group were shortened , Blood loss increased (P <0.05). No intraoperative and postoperative complications occurred in either group. Conclusions Both PCNL and RLU are effective surgical methods for the treatment of incarcerated ureteral calculi. The removal rate and safety of stones are high. However, PCNL and hospitalization time are short and have obvious advantages in postoperative rehabilitation. It is worth further clinical promotion.