输尿管镜联合封堵器与斜卧截石联合体位微创经皮肾镜治疗输尿管上段嵌顿性结石比较

发布时间：2018-05-02 02:07

本文选题：输尿管镜碎石取石术 + 封堵器　；参考：《实用医学杂志》2017年13期

【摘要】：目的比较输尿管镜联合封堵器与斜卧截石联合体位微创经皮肾镜治疗输尿管上段嵌顿性结石的临床治疗效果。方法回顾性分析2014年1月至2016年12月在我院住院行手术治疗的97例输尿管上段嵌顿性结石患者。随机分成两组:输尿管镜联合封堵器组,52例;微创经皮肾镜组,45例。两组间性别、年龄、结石大小无明显差异。结果微创经皮肾镜组和输尿管镜联合封堵器组的术中、术后各项指标分别为:手术时间(78.2±14.1)min vs.(53.3±12.4)min(P0.05),手术成功率为97.8%vs.94.2%(P0.05),结石清除率为100%vs.91.8%(P0.05),并发症发生率为4.4%vs.3.9%(P0.05),住院时间(9.1±3.2)d vs.(5.5±1.4)d(P0.05)。所有患者均未出现感染性休克,无输尿管损伤、肠道损伤等并发症。结论输尿管镜联合封堵器和斜卧截石联合体位微创经皮肾镜均是治疗输尿管上段嵌顿性结石的安全、有效的手术方式。具体术式的选择须根据患者的病情特点和医生的手术经验等因素综合考虑。
[Abstract]:Objective to compare the clinical effect of ureteroscopy combined with occluder and oblique recumbent lithotomy combined with minimally invasive percutaneous nephroscopy in the treatment of upper ureteral incarcerated calculi. Methods 97 patients with upper ureteral incarcerated calculi who were hospitalized in our hospital from January 2014 to December 2016 were analyzed retrospectively. They were randomly divided into two groups: ureteroscope combined with occluder group (n = 52) and minimally invasive percutaneous nephroscopy group (n = 45). There was no significant difference in sex, age and stone size between the two groups. Results in the minimally invasive percutaneous nephroscope group and ureteroscopy combined occluder group, the operative time was 78.2 卤14.1)min vs.(53.3 卤12.4min P0.05, the success rate was 97.8vs.94.2p0.05, the stone clearance rate was 100vs.91.8crest, the complication rate was 4.4vs.3.9m P0.05a, and the hospitalization time was 9.1 卤3.2d vs.(5.5 卤1.4dP0.05. No septic shock, no ureteral injury or intestinal injury were found in all patients. Conclusion the combination of ureteroscopic occluder and oblique recumbent lithotomy combined with minimally invasive percutaneous nephroscopy is a safe and effective method for the treatment of upper ureteral incarcerated calculi. The choice of operation method should be considered according to the patient's condition and the doctor's operation experience.
【作者单位】：广东省梅州市人民医院泌尿外一科;广东省梅州市人民医院外四科;广州医科大学附属第五医院泌尿外科;
【基金】：基金项目:广东省梅州市医药卫生立项(编号:2015-B-3)
【分类号】：R699.4

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