摘要
目的比较体外冲击波碎石(ESWL)、输尿管镜碎石(URL)联合ESWL、微创经皮肾镜取石(MPCNL)治疗输尿管上段结石伴轻、中度肾积水的疗效。方法回顾性分析2008年1月至2010年6月本院治疗的输尿管上段结石伴轻中度肾积水386例,其中ESWL 266例(ESWL1,结石直径不超过1 cm,166例;ESWL2,结石直径大于1 cm,100例),URL联合ESWL 78例,MPCNL 42例。结果 3种方法一次碎石成功率分别为62.8%(167/266)、97.4%(76/78)、100.0%(42/42);术后1个月结石清除率分别为58.3%(155/266)、89.7%(70/78)、100.0%(42/42);平均费用分别为(2 382.2±153.4)元(、9 345.3±586.3)元、(15 007.4±671.1)元;术后并发症发生率分别为9.8%(26/266)、7.7%(6/78)、9.5%(4/42)。一次碎石成功率、术后1个月结石清除率、平均费用3组比较差异有统计学意义(P<0.01),以MPCNL最高,ESWL最低。3组术后并发症发生率比较差异无统计学意义(P>0.05)。ESWL1与ESWL2术后1个月结石清除率分别为68.7%(114/166)、41.0%(41/100),两组比较差异有统计学意义(P<0.01)。结论 MPCNL及URL联合ESWL治疗输尿管上段结石合并轻、中度肾积水高效、安全,结石直径小于1 cm者,宜首选ESWL治疗。
Objective To compare the efficacy of three procedures,extracorporeal shock wave lithotripsy（ESWL）,ureteroscopic lithotripsy（URL）combined with ESWL,minimally invasive percataneous nephrolithotomy（MPCNL）,for the treatment of upper ureteral calculi with un-severe hydronephrosis.Methods 386 cases of upper ureteral calculi with un-severe hydronephrosis had been treated in this hospital from January 2008 to June 2010,including 266 cases of ESWL（ESWL group was subdivided into ESWL1 and ESWL2 according to the stones diameter below 1 cm or above 1 cm.ESWL1 266 cases;ESWL2 100 cases）,78 cases of URL＋ESWL,42 cases of MPCNL.Results In these 3 groups,the stone fragmentation rates were 62.8%（167/266）,97.4%（76/78）,100.0%（42/42）,respectively And the stone-free rates one month after operation were 58.3%（155/266）,89.7%（70/78）,100.0%（42/42）,respectively.The mean hospitalization expenditures were（2 382.2±153.4） yuan,（9 345.3±586.3） yuan,（15 007.4±671.1） yuan,respectively,showing significant difference.The incidences of postoperative complications were 9.8%（26/266）,7.7%（6/78）,9.5%（4/42）,respectively,showing no significant difference（P0.05）.The ESWL group was subdivided into ESWL1 and ESWL2 according to the stones diameter below 1 cm or above 1 cm,showing the stone-free rates one month after ESWL1 and ESWL2 were 68.7%（114/166） and 41.0%（41/100）,respectively,with showing significant difference（P0.01）.Conclusion MPCNL and（URL＋ESWL） are safe and effective for the treatment of upper ureteral calculi with un-severe hydronephrosis.ESWL is the best option with stone smaller than diameter 1 cm.
出处
《重庆医学》
CAS
CSCD
北大核心
2011年第23期2321-2323,共3页
Chongqing medicine
关键词
输尿管结石
碎石术
高能量冲击波
输尿管镜
穿刺术
upper ureteral calculi
extracoproreal shock wave lithotripsy
ureteroscopic lithotripsy
minimaly invasive percutaneous
