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目的探究微创经皮输尿管镜(MPCNL)与逆行输尿管镜(URL)治疗输尿管上段结石的临床效果,为今后的治疗工作提供参考依据。方法选取汨罗市人民医院泌尿外科2011年7月至2013年7月收治的80例嵌顿性输尿管上段结石患者作为研究对象,按照手术方式的不同分为A组与B组,每组40例,A组给予经皮输尿管镜治疗,B组给予逆行输尿管镜治疗,观察两组患者的治疗效果与并发症情况。结果两组患者手术时间、术中出血量、住院天数、手术成功率、两个月后的结石清除率比较差异有统计学意义(P<0.05),两组患者术后并发症比较差异未见统计学意义(P>0.05)。结论微创经皮输尿管镜相比逆行输尿管镜治疗嵌顿性输尿管上段结石的效果更显著,清除结石的效果更好,但手术时间较长,治疗费用较贵;而逆行输尿管镜效果稍差,联合体外冲击波碎石术治疗效果较好。
Objective To explore the clinical effect of minimally invasive percutaneous ureteroscopy (MPCNL) and retrograde ureteroscopy (URL) in the treatment of upper ureteral calculi, and to provide a reference for the future treatment. Methods Eighty patients with incarcerated ureteral calculi in the Department of Urology, People’s Hospital of Miluo City from July 2011 to July 2013 were selected as study subjects and divided into A group and B group according to the different surgical methods, 40 cases in each group, Group A was given percutaneous ureteroscopy, Group B was treated by retrograde ureteroscopy, and the therapeutic effect and complications of the two groups were observed. Results The operation time, intraoperative blood loss, hospitalization days, operation success rate and stone clearance rate after two months were significantly different between the two groups (P <0.05). There was no significant difference in postoperative complications between the two groups Statistical significance (P> 0.05). Conclusions Compared with retrograde ureteroscopy, ureteroscopic retrograde ureteroscopy is more effective in treating upper incarcerated ureteral calculi, the effect of removing stone is better, but the operation time is longer and the cost of treatment is more expensive. However, the effect of retrograde ureteroscopy is slightly worse, Combined extracorporeal shock wave lithotripsy is better.