一期与分期输尿管软镜治疗双侧上尿路结石的疗效比较

发布时间：2019-03-27 12:00

【摘要】：目的探讨一期与分期输尿管软镜下碎石术(flexible ureteroscopic lithotripsy,FURL)治疗双侧上尿路结石的临床疗效。方法我院2012年9月~2015年5月一期输尿管软镜下钬激光碎石术治疗双侧上尿路结石29例(一期手术组),分期输尿管软镜治疗双侧上尿路结石20例(分期手术组),比较2组总手术时间、总住院时间、结石清除率、并发症发生率。结果 2组患者均顺利完成手术。一期手术组总手术时间明显短于分期手术组[(71.0±19.0)min vs.(112.6±26.8)min,t=-6.366,P=0.000],2组总住院时间无统计学差异[(6.9±3.6)d vs.(8.4±2.1)d,t=-1.674,P=0.101]。2组患者术后4周结石清除率分别为79.3%(23/29)、80.0%(16/20),无统计学差异(χ~2=0.000,P=1.000);2组术后并发症发生率无统计学差异[20.7%(6/29)vs.15.0%(3/20),χ~2=0.017,P=0.896]。结论一期双侧输尿管软镜钬激光碎石术可有效、安全治疗双侧上尿路结石,但仍需严格把握手术适应证。
[Abstract]:Objective to evaluate the clinical efficacy of primary and staging ureteroscopic lithotripsy (flexible ureteroscopic lithotripsy,FURL) in the treatment of bilateral upper urinary tract calculi. Methods from September 2012 to May 2015, 29 cases of bilateral upper urinary tract stones were treated with holmium: YAG laser lithotripsy, and 20 cases of bilateral upper urinary tract stones were treated by stage soft ureteroscopy. The total operation time, total hospital stay, stone clearance rate and complication rate were compared between the two groups. Results the operation was successfully completed in both groups. The total operative time in the primary operation group was significantly shorter than that in the staged operation group [(71.0 卤19.0) min vs. (112.6 卤26.8) min,t=-6.366,P=0.000]. There was no significant difference in the total length of hospitalization between the two groups [(6.9 卤3.6) d vs. (8.4 卤2.1) days, t = 1.674, P = 0.101]. The stone clearance rates of the two groups were 79.3% (23 / 29) at 4 weeks after operation, respectively. 80.0% (16 / 20), there was no statistical difference (蠂 ~ 2 / 0.000, P = 1.000). There was no significant difference in postoperative complications between the two groups [20.7% (6 / 29) vs.15.0% (3 / 20), 蠂 ~ 2 / 0.017, P = 0.896]. Conclusion one-stage bilateral ureteroscopic holmium: YAG laser lithotripsy is effective and safe in the treatment of bilateral upper urinary tract calculi, but the indication of operation should be strictly grasped.
【作者单位】：上海交通大学医学院附属新华医院泌尿外科;
【分类号】：R699

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