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目的:比较腹腔镜与传统开放手术行输尿管切开取石术治疗输尿管结石的临床效果,评价腹腔镜手术的优势。方法:回顾性分析我院2011年9月~2013年2月45例行开放输尿管切开取石术(开放组)与33例行腹腔镜输尿管切开取石术(腹腔镜组)患者的临床资料并进行比较。结果:78例手术均取石成功,腹腔镜组2例分别因结石逃逸入肾盂和输尿管炎症水肿粘连明显改行开放手术。腹腔镜组在术中出血量、术后下床时间、肛门排气时间、术后引流总量、术后引流时间、住院天数方面均显著优于开放组,而手术时间及住院总费用显著高于开放组,差异均有统计学意义(P<0.05)。两组患者术后均未出现尿瘘、伤口愈合不良、严重血尿等并发症。结论:两组术式治疗输尿管结石均能有效取石,腹腔镜术式在很多方面拥有一定优势,传统切开取石也有自己的特点。临床上应综合考虑患者意愿、病情特点、术者操作水平、患方经济条件等一系列因素决定最终手术方式。
OBJECTIVE: To compare the clinical effects of laparoscopic ureterolithotomy with conventional open surgery in the treatment of ureteral calculi and to evaluate the advantages of laparoscopic surgery. Methods: The clinical data of 45 patients undergoing open ureterolithotomy (open group) and 33 patients undergoing laparoscopic ureterolithotomy (laparoscopic group) from September 2011 to February 2013 were retrospectively analyzed. Compare. Results: All 78 cases were successful in operation, and 2 cases of laparoscopic group escaped into the renal pelvis due to the stones and ureter inflammation, edema and adhesions were obviously diverted open surgery. Laparoscopic group was significantly better than the open group in the amount of bleeding, postoperative bed time, anus exhaust time, postoperative drainage, postoperative drainage time, length of stay in the open group, while the operation time and hospitalization costs were significantly higher In the open group, the differences were statistically significant (P <0.05). No postoperative urinary fistula, poor wound healing, severe hematuria and other complications occurred in both groups. Conclusion: Both groups can effectively remove stones in the treatment of ureteral calculi. Laparoscopic surgery has some advantages in many aspects. Traditional stone removal has its own characteristics. Clinic should take into account the patient’s wishes, the characteristics of the disease, the surgeon’s level of operation, the economic conditions of the affected party and a series of factors determine the final surgical approach.