微创经皮肾穿刺取石和经尿道输尿管镜碎石治疗嵌顿性输尿管上段结石的疗效对比分析(1)
摘 要：目的 研究微创经皮肾穿刺取石(MPCNL)和经尿道输尿管镜碎石(URL)治疗嵌顿性输尿管上段结石的临床疗效。方法 回顾分析2016年4月～2017年4月在我院治疗的108例嵌顿性输尿管上段结石患者，随机分为对照组和观察组，每组54例。对照组采用URL治疗，观察组采用MPCNL治疗，对比两组患者临床结石清除率、手术指标以及并发症发生情况。结果 观察组术后清石率高于对照组，差异有统计学意义(P<0.05)；观察组手术时间、住院时间、术中出血量、术后并发症发生率均低于对照组，差异有统计学意义(P<0.05)。结论 MPCNL治疗嵌顿性输尿管上段结石清石效果优于URL术，且术后并发症少，手术安全有效，可作为治疗嵌顿性输尿管上段结石的方法。
关键词：微创；经皮肾穿刺；输尿管镜碎石；输尿管上段结石
中图分类号：R699.4 文献标识码：A DOI：10.3969/j.issn.1006-1959.2018.07.034
, http://www.100md.com
文章编号：1006-1959(2018)07-0106-02
Comparative Analysis of Minimally Invasive Percutaneous Nephrolithotomy and Transurethral Ureteroscopic Lithotripsy for the Treatment of Incarcerated Upper Ureteral Calculi
ZHOU Jing，ZHANG Ting-Long，YONG Mian，ZHOU Ming-gui
(Department of Urology，People's Hospital of Yingshan County，Nanchong 637700，Sichuan，China)
Abstract：Objective To study the clinical effect of minimally invasive percutaneous nephrolithotomy(MPCNL)and transurethral ureteroscopic lithotripsy(URL)in the treatment of incarcerated upper ureteral calculi.Methods 108 patients with incarcerated upper ureteral calculi treated in our hospital from April 2016 to April 2017 were randomly divided into control group(n=54)and observation group(n=54).The patients in the control group were treated with URL，and the patients in the observation group were treated with MPCNL.The clinical stone clearance rate， surgical indexes and complications were compared between the two groups.Results The stone clearance rate in the observation group was significantly higher than that in the control group，the difference was statistically significant(P<0.05).The operative time，hospital stay，blood loss and postoperative complications in the observation group were significantly lower than those in the control group，the difference was statistically significant(P<0.05).Conclusion MPCNL is more effective than URL in the treatment of upper ureteral calculi.It has fewer complications and is safe and effective.It can be used as a method for the treatment of incarcerated upper ureteral calculi.
, 百拇医药
Key words：Minimally invasive；Percutaneous renal puncture；Ureteroscopic lithotripsy；Upper ureteral calculi
輸尿管上段结石发生率较高，临床治疗通常采用体外碎石，但是嵌顿性结石治疗效果不佳[1]。微创经皮肾镜取石术(MPCNL)以其创伤小、结石清除率高、并发症少等特点，广泛应用于输尿管上段结石临床治疗中。选取2016年4月～2017年4月在我院治疗的108例嵌顿性输尿管上段结石患者临床资料，对比分析MPCNL和经尿道输尿管镜碎石(URL)治疗嵌顿性输尿管上段结石的治疗效果，现报告如下。
1资料与方法
1.1一般资料 选取2016年4月～2017年4月在营山县人民医院治疗的108例嵌顿性输尿管上段结石患者，本研究经医院伦理会批准。纳入标准：①术前均进行B超、CT、逆行造影检查，均符合输尿管上段结石的诊断指南[2]；②结石直径6～12 mm；③均伴有不同程度的积水；④患者签署知情同意书。排除资料不全者以及其他合并症患者。以随机数字表法将患者分为对照组和观察组，每组54例。对照组男30例，女24例；年龄26～60岁，平均年龄(39.20±5.34)岁；结石大小0.6～1.0 cm，平均大小(1.30±0.22)cm；病程2～17个月，平均病程(5.16±1.03)个月。观察组男29例，女25例；年龄25～58岁，平均年龄(38.92±5.10)岁；结石大小0.9～1.2 cm，平均大小(1.32±0.26)cm；病程2～16个月，平均病程(5.62±1.12)个月。两组患者性别、年龄、结石大小、病程等基础资料相比，差异无统计学意义(P>0.05)，有可比性。, http://www.100md.com(周静 张廷龙 雍勉 周明贵)
关键词：微创；经皮肾穿刺；输尿管镜碎石；输尿管上段结石
中图分类号：R699.4 文献标识码：A DOI：10.3969/j.issn.1006-1959.2018.07.034
, http://www.100md.com
文章编号：1006-1959(2018)07-0106-02
Comparative Analysis of Minimally Invasive Percutaneous Nephrolithotomy and Transurethral Ureteroscopic Lithotripsy for the Treatment of Incarcerated Upper Ureteral Calculi
ZHOU Jing，ZHANG Ting-Long，YONG Mian，ZHOU Ming-gui
(Department of Urology，People's Hospital of Yingshan County，Nanchong 637700，Sichuan，China)
Abstract：Objective To study the clinical effect of minimally invasive percutaneous nephrolithotomy(MPCNL)and transurethral ureteroscopic lithotripsy(URL)in the treatment of incarcerated upper ureteral calculi.Methods 108 patients with incarcerated upper ureteral calculi treated in our hospital from April 2016 to April 2017 were randomly divided into control group(n=54)and observation group(n=54).The patients in the control group were treated with URL，and the patients in the observation group were treated with MPCNL.The clinical stone clearance rate， surgical indexes and complications were compared between the two groups.Results The stone clearance rate in the observation group was significantly higher than that in the control group，the difference was statistically significant(P<0.05).The operative time，hospital stay，blood loss and postoperative complications in the observation group were significantly lower than those in the control group，the difference was statistically significant(P<0.05).Conclusion MPCNL is more effective than URL in the treatment of upper ureteral calculi.It has fewer complications and is safe and effective.It can be used as a method for the treatment of incarcerated upper ureteral calculi.
, 百拇医药
Key words：Minimally invasive；Percutaneous renal puncture；Ureteroscopic lithotripsy；Upper ureteral calculi
輸尿管上段结石发生率较高，临床治疗通常采用体外碎石，但是嵌顿性结石治疗效果不佳[1]。微创经皮肾镜取石术(MPCNL)以其创伤小、结石清除率高、并发症少等特点，广泛应用于输尿管上段结石临床治疗中。选取2016年4月～2017年4月在我院治疗的108例嵌顿性输尿管上段结石患者临床资料，对比分析MPCNL和经尿道输尿管镜碎石(URL)治疗嵌顿性输尿管上段结石的治疗效果，现报告如下。
1资料与方法
1.1一般资料 选取2016年4月～2017年4月在营山县人民医院治疗的108例嵌顿性输尿管上段结石患者，本研究经医院伦理会批准。纳入标准：①术前均进行B超、CT、逆行造影检查，均符合输尿管上段结石的诊断指南[2]；②结石直径6～12 mm；③均伴有不同程度的积水；④患者签署知情同意书。排除资料不全者以及其他合并症患者。以随机数字表法将患者分为对照组和观察组，每组54例。对照组男30例，女24例；年龄26～60岁，平均年龄(39.20±5.34)岁；结石大小0.6～1.0 cm，平均大小(1.30±0.22)cm；病程2～17个月，平均病程(5.16±1.03)个月。观察组男29例，女25例；年龄25～58岁，平均年龄(38.92±5.10)岁；结石大小0.9～1.2 cm，平均大小(1.32±0.26)cm；病程2～16个月，平均病程(5.62±1.12)个月。两组患者性别、年龄、结石大小、病程等基础资料相比，差异无统计学意义(P>0.05)，有可比性。, http://www.100md.com(周静 张廷龙 雍勉 周明贵)