后腹腔镜与开放手术治疗输尿管结石的对比分析(1)
[摘要]目的 比较腹腔镜输尿管切开取石与开放手术治疗输尿管结石的效果。方法 收集并筛选2011年1月～2016年10月入我院经手术治疗的51例输尿管结石患者，依据手术方法分为观察组(27例)和对照组(24例)。观察组行后腹腔镜输尿管切开取石术，对照组行开放输尿管切开取石术，比较两组的治疗效果。结果 观察组的术中出血量少于对照组，胃肠功能恢复时间、下床活动时间、术后住院时间短于对照组，差异有统计学意义(P<0.05)。观察组的手术时间长于对照组，差异有统计学意义(P<0.05)。两组的引流管留置时间比较，差异无统计学意义(P>0.05)。结论 后腹腔镜治疗输尿管结石中的临床效果确切，手术创伤较小，术后恢复快，适合临床推广。
[关键词]后腹腔镜；输尿管切开取石术；输尿管结石；对照研究
[中图分类号] R693+.4 [文献标识码] A [文章编号] 1674-4721(2017)03(a)-0073-03
[Abstract]Objective To compare the efficacy of laparoscopic ureterolithotomy and open surgery in the treatment of ureteral calculi.Methods 51 patients with ureteral calculi who were given surgical treatment in our hospital from January 2011 to October 2016 were collected and screened.They were divided into the observation group (27 cases) and the control group (24 cases) according to the surgical procedures.The observation group was given retroperitoneal laparoscopic ureterolithotomy，and the control group was given open ureterolithotomy.The therapeutic effects of the two groups was compared.Results The amount of intraoperative bleeding in the observation group was less than that in the control group，the recovery time of gastrointestinal function，ambulation time，postoperative hospital stay in the observation group was shorter than that in the control group，with significant difference (P<0.05).The operation time of the observation group was longer than that of the control group，with significant difference (P<0.05).There was no significant difference between the two groups in the indwelling time of drainage tube (P>0.05).Conclusion The clinical effect of retroperitoneal laparoscope in the treatment of ureteral calculi is obvious，the trauma is small，and the postoperative recovery is fast，which is suitable for clinical promotion.
[Key words]Retroperitoneal laparoscope；Open ureterolithotomy；Ureteral calculi；Comparative study
泌尿系结石是泌尿外科的常见病种，上尿路结石是其中最高发病种，青壮年多发，多为男性，双侧患病者占5%～10%。输尿管结石在上尿路结石中所占的比例约为65%，中国输尿管结石的发病率为0.12%～6.02%[1]，南方发病率明显较北方高，两广地区尤甚。输尿管结石与肾结石成分相似，以单纯性草酸钙结石或草酸钙和磷酸钙混合性结石为主。饮食、气候、季节、社会经济环境、遗传因素等对泌尿系结石患病均有影响[2]。
传统的开放性手术治疗输尿管结石的效果较好，但手术创伤较大，且术后恢复较慢，手术创伤增加了患者的痛苦。随着外科微创技术的不断发展，腹腔镜微创手术在临床中得到了广泛应用，对泌尿系疾病尤其具有极好的治疗效果[3]。本研究旨在探讨腹腔镜技术治疗输尿管结石的效果，现报道如下。
1资料与方法
1.1一般资料
回顧性收集2011年1月～2016年10月收治入院行手术干预的输尿管结石病例，依据下列标准筛选：①单侧输尿管结石；②未合并急需处理的同侧肾结石；③凝血功能、肝肾功能正常；④围术期未合并消化系统疾病。共纳入研究51例，依照不同手术方法分为观察组(27例)和对照组(24例)。观察组中，男16例，女11例；年龄为19～76岁，平均(44.4±3.6)岁；结石平均长径1.8 cm。对照组中，男14例，女10例；年龄22～70岁，平均(39.1±2.3)岁；结石平均长径2.1 cm。两组的年龄、性别、结石大小等一般资料比较，差异无统计学意义(P>0.05)，具有可比性。 (韦兴聪 韦巍 唐松林)
[关键词]后腹腔镜；输尿管切开取石术；输尿管结石；对照研究
[中图分类号] R693+.4 [文献标识码] A [文章编号] 1674-4721(2017)03(a)-0073-03
[Abstract]Objective To compare the efficacy of laparoscopic ureterolithotomy and open surgery in the treatment of ureteral calculi.Methods 51 patients with ureteral calculi who were given surgical treatment in our hospital from January 2011 to October 2016 were collected and screened.They were divided into the observation group (27 cases) and the control group (24 cases) according to the surgical procedures.The observation group was given retroperitoneal laparoscopic ureterolithotomy，and the control group was given open ureterolithotomy.The therapeutic effects of the two groups was compared.Results The amount of intraoperative bleeding in the observation group was less than that in the control group，the recovery time of gastrointestinal function，ambulation time，postoperative hospital stay in the observation group was shorter than that in the control group，with significant difference (P<0.05).The operation time of the observation group was longer than that of the control group，with significant difference (P<0.05).There was no significant difference between the two groups in the indwelling time of drainage tube (P>0.05).Conclusion The clinical effect of retroperitoneal laparoscope in the treatment of ureteral calculi is obvious，the trauma is small，and the postoperative recovery is fast，which is suitable for clinical promotion.
[Key words]Retroperitoneal laparoscope；Open ureterolithotomy；Ureteral calculi；Comparative study
泌尿系结石是泌尿外科的常见病种，上尿路结石是其中最高发病种，青壮年多发，多为男性，双侧患病者占5%～10%。输尿管结石在上尿路结石中所占的比例约为65%，中国输尿管结石的发病率为0.12%～6.02%[1]，南方发病率明显较北方高，两广地区尤甚。输尿管结石与肾结石成分相似，以单纯性草酸钙结石或草酸钙和磷酸钙混合性结石为主。饮食、气候、季节、社会经济环境、遗传因素等对泌尿系结石患病均有影响[2]。
传统的开放性手术治疗输尿管结石的效果较好，但手术创伤较大，且术后恢复较慢，手术创伤增加了患者的痛苦。随着外科微创技术的不断发展，腹腔镜微创手术在临床中得到了广泛应用，对泌尿系疾病尤其具有极好的治疗效果[3]。本研究旨在探讨腹腔镜技术治疗输尿管结石的效果，现报道如下。
1资料与方法
1.1一般资料
回顧性收集2011年1月～2016年10月收治入院行手术干预的输尿管结石病例，依据下列标准筛选：①单侧输尿管结石；②未合并急需处理的同侧肾结石；③凝血功能、肝肾功能正常；④围术期未合并消化系统疾病。共纳入研究51例，依照不同手术方法分为观察组(27例)和对照组(24例)。观察组中，男16例，女11例；年龄为19～76岁，平均(44.4±3.6)岁；结石平均长径1.8 cm。对照组中，男14例，女10例；年龄22～70岁，平均(39.1±2.3)岁；结石平均长径2.1 cm。两组的年龄、性别、结石大小等一般资料比较，差异无统计学意义(P>0.05)，具有可比性。 (韦兴聪 韦巍 唐松林)