两种微方法治疗输尿管上段结石效果比较.docVIP

两种微创方法治疗输尿管上段结石效果比较 　　【摘要】 目的：研究治疗输尿管上段结石患者采取硬性或软输尿管镜碎石取石术（URL）和后腹腔镜输尿管切开取石术（RLUL）两种微创方法治疗的临床效果。方法：选择2011年1月-2016年7月笔者所在医院纳入的100例输尿管上段结石患者。按照随机数原则将100例患者分为URL组和RLUL组，各50例。比较两组患者的临床效果。结果：RLUL组手术时间及住院时间均明显高于URL组，差异均有统计学意义（P0.05）。结论：RLUL 治疗输尿管上段较大体积结石具创伤小、成功率高等特点，URL可真正做到无创，此外操作简单，术后恢复快，但对于无法有效探查输尿管开口的患者则无法适用，应根据结石部位、大小及是否合并输尿管狭窄、畸形等病变等综合考虑术式的选择，以达到最好的临床效果。 中国论文网 /6/viewhtm　　【关键词】 URL； RLUL； 输尿管上段结石； 疗效 　　doi：10.14033/j.cnki.cfmr.2017.25.006 文献标识码 B 文章?号 1674-6805（2017）25-0012-02 　　【Abstract】 Objective： To compare the clinical effect of URL （ureterorenoscope lithotripsy） and RLUL （retroperitoneallaparoscopic ureterolithotomy） in the treatment of upper ureteral calculi.Method：100 patients with upper ureteral calculi treated from January 2011 to December 2016 in the author’s hospital were selected.The subjects were randomly divided into URL group and RLUL group，50 cases of each group.The operation time，hospitalization time，one-time removal rate and removal rate after 4w of surgery for two groups was compared.Result：The operation time and hospitalization time of RLUL group were significantly longer than URL group， the difference was statistically significant（P0.05）.Conclusion：For patients with large volume of upper ureteral calculi，the RLUL can reduce the clinical trauma and improve the success rate.The URL minimally invasive surgery is easy to operate and promotes the patient’s recovery，but it is difficult to effectively explore the opening of ureter.According to the location and size of calculus and complications of ureterostenosis and malformation，it shall be cautious to select the most appropriate operation methods. 　　【Key words】 URL； RLUL； Upper ureteral calculi； Clinical effect 　　First-author’s address：Xuzhou Central Hospital，Xuzhou 221000，China 　　输尿管上段结石容易引发尿路梗阻从而出现肾功能衰竭。一般来说，输尿管上段的结石体外碎石效果较好，但如果结石太大或嵌顿性结石时体外碎石往往失败，此时可采用微创手术切开取石[1]。硬性或软输尿管镜碎石取石术（ureterorenoscope lithotripsy，URL）及后腹腔镜输尿管切开取石术（retroperitoneallaparoscopic ureterolithotomy，RLUL）是临床最为广泛采用的两