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目的比较微创经皮肾镜取石术和单孔后腹腔镜输尿管切开取石术治疗输尿管上段结石的效果。方法2013年1月—2014年10月收治的400例输尿管上段结石患者入选本研究,按照数字随机法分为2组,对照组采取微创经皮肾镜取石术治疗,观察组采取单孔后腹腔镜输尿管切开取石术治疗,比较2组患者手术一般情况及结石清除率及术后并发症发生率。结果观察组患者手术时间为(99.8±21.6)min,显著长于对照组的(56.9±19.6)min,P<0.05;观察组患者术中血红蛋白下降水平为(0.4±0.1)g/L,显著低于对照组的(0.7±0.2)g/L,P<0.05。观察组术后肉眼血尿持续时间、术后下床活动时间及住院时间分别为(0.9±0.4)d、(1.2±0.7)d、(3.6±0.9)d,均明显短于对照组(3.6±1.3)d、(4.3±1.2)d、(5.4±1.7)d,差异具有统计学意义,均P<0.05。观察组结石清除率为100.0%(200/200),显著高于对照组的95.5%(191/200),P<0.05;观察组患者术后并发症3例(1.5%),显著低于对照组40例(20.0%),P<0.05。结论单孔后腹腔镜输尿管切开取石术治疗输尿管上段结石效果较佳,但手术时间较长,术后并发症发生率低,具有重要的临床价值。
Objective To compare the effect of minimally invasive percutaneous nephrolithotomy and single-hole laparoscopic ureterolithotomy for upper ureteral calculi. Methods From January 2013 to October 2014, 400 patients with upper ureteral calculi were enrolled in this study. The patients were divided into two groups according to the random number method. The control group was treated with minimally invasive percutaneous nephrolithotomy. The observation group was treated with single hole Laparoscopic ureterolithotomy treatment, the two groups were compared the general situation of surgery and stone clearance and postoperative complications. Results The operation time of the observation group was (99.8 ± 21.6) min, significantly longer than that of the control group (56.9 ± 19.6) min, P <0.05. The decrease of hemoglobin in the observation group was (0.4 ± 0.1) g / L, (0.7 ± 0.2) g / L in the control group, P <0.05. The gross hematuria duration, postoperative ambulation time and hospital stay in the observation group were (0.9 ± 0.4) days, (1.2 ± 0.7) days and (3.6 ± 0.9) days, respectively, which were significantly shorter than those in the control group (3.6 ± 1.3) d, (4.3 ± 1.2) d, (5.4 ± 1.7) d respectively. The difference was statistically significant (P <0.05). The stone clearance rate in the observation group was 100.0% (200/200), significantly higher than that in the control group (95%) (191/200), P <0.05; 3 cases (1.5%) in the observation group were significantly lower than the control group Group 40 cases (20.0%), P <0.05. Conclusion Single hole laparoscopic ureterolithotomy is superior to the upper ureteral calculi, but the operation time is longer, the incidence of postoperative complications is low, which has important clinical value.