摘要
目的:比较经皮肾镜取石术(percutaneous nephrolithotomy,PCNL)和后腹腔镜下输尿管切开取石术(retro-peritoneal laparoscopic ureterolithotomy,RLU)治疗复杂性输尿管上段结石的疗效。方法:回顾性分析71例复杂性输尿管上段结石患者临床资料,PCNL组31例和RLU组40例,对比两组病例手术时间、术后1周结石清除率、手术并发症。结果:71例手术全部成功,手术时间PCNL组[(48.52±17.51)min]短于RLU组[(87.43±22.63)min],差异有统计学意义(P<0.01)。术后1周结石清除率PCNL组为96.8%(30/31),RLU组100%(40/40),两组比较差异无统计学意义(P>0.05)。术中、术后均无明显出血及周围脏器损伤等并发症。术后随访3～10个月,平均7个月,两组均未发现结石复发及输尿管狭窄。结论:PCNL和RLU治疗复杂性输尿管上段结石均是安全、有效的方法。复杂性输尿管上段结石的治疗可视患者具体情况、单位设备条件、术者经验酌情选择PCNL或RLU。
Objective： To evaluate the effect of the percutaneous nephrolithotomy（PCNL） in the management of complicated upper ureteric calculi,comparing with retroperitoneal laparoscopic ureterolithotomy（RLU）.Methods： Seventy-one cases with complicated upper ureteric calculi were retrospectively investigated（PCNL group 31 cases,RLU group 40 cases）.Clinical data including operation time,stone free rate and the surgical complications were statistically analyzed.Results： All the operations were successful in all 71 cases.As compared to the RLU group,the PCNL group had a significant shorter operation time [（48.52±17.51） min vs（87.43±22.63）min,P〈0.01],and significant difference were detected.A week after the operation,the PCNL group showed a stone free rate of 96.8%（30/31） while the RLU group 100%（40/40）,and no significant difference were detected.No significant complications,such as intraoperative or postoperative bleeding and damage to surrounding organs,were detected.The patients were followed up for 3 to 10 months（mean,7 months）,and no recurrent stones or ureteral stricture were developed during the period.Conclusion： Both PCNL and RLU are safe and effective for complicated upper ureteral calculi.The appropriate method depends on the patients′ specific conditions,the unit equipments and the experience of operator.
出处
《江苏大学学报（医学版）》
CAS
2012年第1期69-72,共4页
Journal of Jiangsu University：Medicine Edition
