输尿管硬镜联合软镜碎石术与微创经皮肾镜取石术处理输尿管上段嵌顿结石的比较

发布时间：2018-03-15 18:36

本文选题：输尿管结石　切入点：经皮肾镜取石术　出处：《中国微创外科杂志》2017年11期 　论文类型：期刊论文

【摘要】：目的比较输尿管硬镜联合软镜碎石术与微创经皮肾镜取石术(minimally invasive percutaneous nephrolithotomy,MPCNL)治疗嵌顿性输尿管上段结石的有效性及安全性。方法回顾性分析2010年6月~2015年4月我院102例嵌顿性输尿管上段结石的临床资料,根据治疗方法分为2组,双镜联合治疗54例(双镜联合组),MPCNL治疗48例(MPCNL组),比较2组手术时间、术中出血量、术后住院时间、结石清除率及手术并发症。结果所有患者均耐受手术,无严重并发症发生。双镜联合组手术时间(87.9±21.6)min,显著长于MPCNL组(61.5±16.7)min(t=-6.795,P=0.000)。MPCNL组术中出血量(52.8±9.6)ml,显著多于双镜联合组(12.5±2.6)ml(t=29.644,P=0.000)。MPCNL组术后住院时间(6.1±1.3)d,明显长于双镜联合组(2.8±0.7)d(t=16.162,P=0.000)。术后并发症发生率2组差异无显著性(χ~2=0.330,P=0.566)。术后1个月结石清除率MPCNL组为95.7%(45/47),双镜联合组为94.4%(51/54),2组差异无显著性(χ2=0.000,P=1.000)。结论输尿管硬镜联合软镜碎石术与MPCNL治疗嵌顿性输尿管上段结石均具有满意的疗效与安全性,双镜联合碎石术利用人体自然腔道进行微创操作,不存在对肾实质的直接损伤,具有出血少、创伤小、住院时间短等特点。
[Abstract]:Objective to compare the efficacy and safety of minimally invasive percutaneous lithotripsy and minimally invasive invasive percutaneous lithotripsy in the treatment of upper ureteral calculi from June 2010 to April 2015. Clinical data of incarcerated upper ureteral calculi, According to the treatment method, 54 cases were divided into two groups, 54 cases were treated with double mirror combined with MPCNL (48 cases with MPCNL treated with MPCNL). The time of operation, the amount of intraoperative bleeding, the time of hospitalization after operation were compared between the two groups. Results all patients tolerated the operation. There was no serious complication. The operative time of double mirror combined group was 87.9 卤21.6min, which was significantly longer than that of MPCNL group (61.5 卤16.7 min). The intraoperative bleeding volume was 52.8 卤9.6ml / ml in the MPCNL group, which was significantly higher than that in the double mirror combined group (12.5 卤2.6ml t29.644P0.000.MPCNL), which was significantly longer than that in the MPCNL group (2.8 卤0.7dt 16.162P0. 000). There was no significant difference between the two groups (蠂 2 / 0.330 P < 0. 566). The removal rate of stone in MPCNL group was 95.775 / 47% at one month after operation, and there was no significant difference between the two groups (蠂 2 0. 000). Conclusion both rigid ureteroscopy combined with soft endoscopy lithotripsy and MPCNL have satisfactory results in the treatment of incarcerated upper ureteral calculi. The efficacy and safety of. Dual-mirror combined lithotripsy is a minimally invasive procedure using human natural cavities. There is no direct injury to renal parenchyma, which is characterized by less bleeding, less trauma and short hospitalization time.
【作者单位】：长沙市第一医院泌尿外科;
【分类号】：R699

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