URL及MPCNL治疗输尿管上段结石临床疗效研究.docVIP

URL及MPCNL治疗输尿管上段结石临床疗效研究 　　【摘要】 目的：研究经尿道输尿管镜碎石取石术（URL）、微创经皮肾镜碎石术（MPCNL）治疗输尿管上段结石的临床疗效。方法：选择2008年7月-2014年12月本院收治的输尿管上段结石患者320例作为研究对象，采用随机数字表法将其分为A、B两组，每组160例，分别行URL、MPCNL术治疗，将两组中结石长径1.5 cm的患者分别设为A2、B2组。回顾分析并比较各组术中及术后各项指标。结果：A1、A2组手术时间、术中出血量、术后住院时间、住院费用、术中输血率、继发出血发生率、周围脏器损伤发生率、术后感染发生率、术后疼痛药物使用率均分别低于B1、B2组，比较差异均有统计学意义（P0.05）；B2组术后1个月结石残留发生率明显低于A2组，比较差异有统计学意义（P0.01）。结论：当输尿管上段结石长径大于1.5 cm时首选MPCNL术，它具有非常高的结石清除率；当输尿管上段结石长径小于1.5 cm时首选URL术，它具有和MPCNL相当的结石清除率，并且比MPCNL更安全。 　　【关键词】 经尿道输尿管镜； 微创经皮肾镜； 输尿管上段结石 　　Research on the Clinical Effect of URL and MPCNL in the Treatment of Upper Ureteral Calculi/WAN Yue-ping，LI Hong-yan，XI Ming，et al.//Medical Innovation of China，2016，13（04）：078-081 　　【Abstract】 Objective：To research the clinical effect of transurethral ureteroscopic lithotripsy（URL） and minimally invasive percutaneous nephrolithotomy（MPCNL） in the treatment of upper ureteral calculi.Method：320 cases of upper ureteral calculi patients in our hospital from July 2008 to December 2014 were selected as the research objects.They were randomly divided into group A and group B，with 160 cases in each group.Group A was given URL and group B was given MPCNL.Patients with calculus less than 1.5 cm in the two groups were selected as group A1 and group B1 respectively，patients with calculus longer than 1.5 cm in the two groups were selected as group A2 and group B2 respectively.The indexes of intraoperative and postoperative in each group were retrospectively analyzed and compared.Result：The time of operation，intraoperative blood loss，postoperative hospital stay，hospitalization expenses，intraoperative blood transfusion rate，incidence of secondary bleeding，incidence rate of peripheral viscera injury，incidence of postoperative infection and drug use rate for postoperation pain in group A1 and group B1 were lower than those in group A2 and group B2 respectively，the differences were statistically significant（P0.05）.The incidence rate of calculi residual 1 month after operation in group B