经皮肾镜和输尿管镜治疗输尿管上段结石临床疗效研究.docVIP

经皮肾镜和输尿管镜治疗输尿管上段结石临床疗效研究 　　【摘要】 目的：比较分析微创经皮肾镜（MPCNL）和经尿道输尿管镜（URL）治疗输尿管上段结石的临床疗效和安全性。方法：回顾性分析本院收治的输尿管上段结石158例患者的临床资料，比较MPCNL组和URL组患者的结石清除率、手术时间、术中出血量、住院时间和并发症发生率。结果：治疗前两组的临床资料比较差异无统计学意义，经治疗后，MPCNL组的结石清除率高于URL组，URL组的手术时间、术中出血量和术后住院时间均比MPCNL组少，差异具有统计学意义（P0.05）。两组的并发症发生率比较差异无统计学意义。结论：在临床中，应根据患者的结石情况、手术适应证和患者的治疗意愿确定最佳的治疗方案，以提高临床疗效和改善患者的满意度。 　　【关键词】 输尿管上段结石； 微创经皮肾镜； 经尿道输尿管镜； 临床疗效 　　Clinical Effect Comparison of Minimally Invasive Percutaneous Nephrolithotomy and Ureteroscopic Lithotripsy for Upper Ureteral Calculi/LI Huan-xiong，HE Li-hua，DAI Xu-hui.//Medical Innovation of China，2015，12（08）：147-149 　　【Abstract】 Objective：To compare the clinical effect and safety of minimally invasive percutaneous nephrolithotomy（MPCNL） and ureteroscopy lithotripsy（URL） for upper ureteral calculi.Method：The clinical data of patients with upper ureteral calculi including MPCNL group and URL group were analyzed，respectively.The calculi clearance rate，operative time，intraoperative blood loss，length of hospital stay and incidence of complications were compared.Result：No significant differences of clinical data were observed between the MPCNL group and URL group before the treatment.After treatment， the calculi clearance rates of MPCNL group were significantly superior to the URL group（P0.05）.Conclusion：The best treatment schedule should be determined according to the patients conditions， surgical indications and patients’ thoughts to achieve good clinical effect and patients’ satisfactory. 　　【Key words】 Upper ureteral calculi； Minimally invasive percutaneous nephrolithotomy； Ureteroscopy lithotripsy； Clinical efficacy 　　First-author’s address：The People’s Hospital of Wuhua County，Wuhua 514400，China 　　doi：10.3969/j.issn.1674-4985.2015.08.053 　　输尿管上段结石是临床泌尿外科的常见病，表现为腰痛、恶心呕吐、尿急、尿痛等[1-2]。临床上主要采用体外冲击波碎石术（ESWL）治疗，但不适用于嵌段性结石、重度积水、结石下方尿路扭曲狭窄或反复多次碎石效果不明显者[3-5]。随着微创手术的发展和患者对生活质量要求的提高，微创手术受到医患人员的欢迎。微创经皮肾镜穿刺取石术（MPCNL）和经输尿管镜碎石术（URL）是临床常用的清除结石的微创术式，术后并发症少，患者痛苦少[6]。本文旨在探讨比较MPCNL和URL微创手术治疗输尿管上段结石的临