腹腔镜输尿管切开术联合软镜取石治疗输尿管中上段结石伴同侧肾结石的临床研究.docVIP

腹腔镜输尿管切开术联合软镜取石治疗输尿管中上段结石伴同侧肾结石的临床研究 　　[摘要] 目的 探讨应用腹腔镜输尿管切开术联合软镜取石治疗输尿管中上段结石伴同侧肾结石的效果。 方法 随机选取2010 年 10 月～2013 年 10 月在我院诊治的输尿管中上段结石伴同侧肾结石患者64例作为研究对象，对其临床资料进行回顾性分析，根据手术方式不同分为两组，行腹腔镜输尿管切开术联合软镜取石术的患者33例设为观察组，接受传统开放性手术的患者31例设为对照组。术后随访 8个月，比较两组患者的临床治疗效果。结果 观察组手术时间、手术出血量、术后排尿恢复时间及住院时间明显少于对照组（P0.05） ；两组患者治疗后的体质量和卡氏评分均高于治疗前，且治疗后的观察组生存质量优于对照组（P0.05）；观察组患者术后并发症发生率显著低于对照组（P0.05）。 结论 腹腔镜输尿管切开术联合软镜取石术治疗效果较好，与传统的开放性手术比较，其治疗输尿管中上段结石伴同侧肾结石的手术创伤较小，术后恢复快，结石的清除率较高，不良反应少，患者生存质量较高，具有临床推广价值。 　　[关键词] 腹腔镜输尿管切开术；软镜取石；输尿管中上段结石；肾结石 　　[中图分类号] R699 [文献标识码] B [文章编号] 1673-9701（2015）14-0033-04 　　[Abstract] Objective To explore and analyze the efficacy of laparoscopic ureterolithotomy combined with flexible ureteroscopy for treatment of middle and upper ureteral calculi with ipsilateral kidney calculi. Methods All 64 cases who were diagnosed with middle and upper ureteral calculi with ipsilateral kidney stones in our hospital from October 2010 to October 2013 were chosen as the research subjects. All of the clinical data were analyzed retrospectively. Patients were divided into observation group（33 cases） who were treated with laparoscopic ureterolithotomy combined with flexible ureteroscopy and the control group （31 cases） who were treated with traditional open surgery randomly.The short-term clinical effects between two groups were compared after 8 months. Results The surgical bleeding，operation time，hospital stays and the recovery time of observation group were all lower than those of control group（P0.05）. The body mass and Karnofsky scores after surgery of two groups were all higher than those before surgery. Quality of life of the observation group was better than that of the control group（P0.05）. The complications rate of the observation group was lower than that of the control group（P0.05）. Conclusion Laparoscopic ureterolithotomy combined with flexible ureteroscopy for treatment of middle and upper ureteral calculi with ipsilateral kidney stones has such advantages as better efficacy，sm