腹膜后腹腔镜与开放手术治疗肾盂输尿管结石的比较
发布时间：2018-04-13 06:35
本文选题：后腹腔镜肾盂输尿管切开取石术 + 肾盂结石 ； 参考：《福建医科大学》2014年硕士论文
【摘要】：目的：探讨腹膜后腹腔镜与开放手术治疗肾盂输尿管结石的疗效及临床应用价值。 方法：回顾性分析福建医科大学附属协和医院2010年1月～2013年12月期间171例上尿路结石手术病例资料，其中101例采用腹膜后腹腔镜肾盂输尿管切开取石术，70例采用开放手术治疗。对比两者间的手术时间、术中出血、肛门排气时间、术后进食时间、下床活动时间、引流管留置时间、术后并发症、结石残留率、术后镇痛药使用次数、术后住院时间及住院费用等。 结果：所有手术均获得成功,两例后腹腔镜手术分别因肾周粘连严重及术中动脉性出血改开放手术治疗，归为开放组。后腹腔镜组与开放组相比，在术中出血（42.43±28.17ml vs151.51±266.25ml）、肛门排气时间（1.15±0.36d vs2.29±0.92d）、术后进食时间（1.73±0.66d vs2.44±0.91d）、下床活动时间（2.25±1.23d vs2.08±0.93d）、结石残留率[1(0.99%) vs8(11.43%)]、并发症发生率[15(14.85%) vs21(30.00%)]、术后住院时间（6.73±2.65d vs9.70±6.91d）、总住院费用（21991.77±6696.36元vs24764.76±9655.87元）等方面明显优于开放组(均P0.05)。而在手术时间(137.4±50.13min vs162.86±109.4min)、引流管留置时间（5.03±2.80d vs5.63±2.17d）、镇痛药使用次数方面（6.67±6.07vs7.05±7.49），两者没有明显的统计学差别（均P0.05）。 结论：后腹腔镜肾盂输尿管切开取石术作为治疗肾盂输尿管结石一种微创手术方式，其具有损伤小、出血少、恢复快、并发症少等优点，现在技术较为成熟，可部分取代传统的开放手术，，但在实际应用中应根据患者病情、经济条件以及术者技术水平等因素综合考虑，合理选择手术方式。
[Abstract]:Objective: to evaluate the efficacy and clinical value of retroperitoneal laparoscopy and open surgery in the treatment of ureteropelvic calculi.Methods: the data of 171 cases of upper urinary calculi from January 2010 to December 2013 in Union Hospital of Fujian Medical University were analyzed retrospectively. Among them, 101 cases were treated by retroperitoneal laparoscopic ureterolithotomy and 70 cases were treated by open surgery.The operative time, intraoperative bleeding, anus exhaust time, postoperative feeding time, the time of getting out of bed, the time of drainage tube indwelling, postoperative complications, the residual rate of stone, the number of times of using analgesics after operation, and the time of analgesics after operation were compared.Postoperative hospital stay and hospitalization expenses.Results: all the operations were successful. Two cases of retroperitoneal laparoscopic surgery were classified as open group due to severe perirenal adhesions and intraoperative arterial hemorrhage.The retroperitoneal laparoscopic group compared with the open group,鍦ㄦ湳涓嚭琛
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