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目的采用经皮肾镜取石术(PCNL)与输尿管镜碎石术(URL)治疗输尿管中上段结石,并比较其疗效。方法从2008年5月至2011年12月,216例单侧输尿管中上段结石,PCNL组126例,URL组90例,URL组在术中配合使用结石套篮,部分病例术后配合ESWL。结果 PCNL组手术成功率为100%(126/126),一次结石清除率为97%(122/126)。URL组手术成功率为72%(65/90),一次结石清除率57%(51/90),术后1个月时结石清除率为87%(78/90),均显著低于PCNL组(P<0.05)。结论 PCNL治疗输尿管中上段结石效果肯定,手术成功率和结石清除率较高;URL疗效稍差,但配合使用套石篮等辅助设备,术后联合ESWL均可显著提高疗效,出血及感染发生率明显低于PCNL组,临床可根据患者情况选择。
Objective To evaluate the effect of percutaneous nephrolithotomy (PCNL) and ureteroscopic lithotripsy (URL) on the upper ureteral calculi. METHODS: From May 2008 to December 2011, 216 patients with unilateral ureteral calculi in upper and middle ureteral calculi were treated with PCNL, 126 cases with URL and 90 cases with URL. Results The success rate of operation in PCNL group was 100% (126/126) and the stone clearance rate was 97% (122/126). The successful rate was 72% (65/90) in the URL group, 57% (51/90) in a stone, and 87% (78/90) in one month postoperatively, which were significantly lower than those in the PCNL group (P <0.05). Conclusion PCNL treatment of upper ureteral calculi sure, the success rate of surgery and stone clearance rate higher; URL less effective, but with the use of stone basket and other auxiliary equipment, postoperative combined with ESWL can significantly improve the efficacy, bleeding and infection rates Obviously lower than the PCNL group, the clinical choice according to the patient’s condition.