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目的探讨微创经皮肾输尿管镜碎石术治疗输尿管上段嵌顿性结石的疗效及预后。方法选取我院2008年1月-2012年2月输尿管上段嵌顿性结石患者80例,随机分两组各40例,分别给予经皮肾输尿管镜取石术(MPCNL)和经尿道输尿管镜取石术治疗,观察两组手术时间和住院时间,并随访1个月,观察治疗1周和1个月后的结石清除率及并发症发生率。结果经皮肾镜组治疗1周和1个月后的结石清除率均达100%,显著高于经尿道输尿管镜组(70%和87.5%),具有统计学差异(P<0.05);经皮肾镜组手术时间和住院时间分别为62.87±3.22min和4.38±1.01d,与经尿道输尿管镜组比较均具有统计学差异(P<0.05)。两组术后感染、发烧、迟发性出血及腹腔脏器损伤等并发症发生率比较无统计学差异(P>0.05)。结论经皮肾输尿管镜碎石术治疗输尿管上段嵌顿性结石的疗效明显,安全性高,方法可靠,可在基层医院广泛开展。
Objective To investigate the curative effect and prognosis of minimally invasive percutaneous nephrolithotomy for the treatment of incarcerated upper ureteral calculi. Methods Eighty patients with incarcerated upper ureteral calculi in our hospital from January 2008 to February 2012 were randomly divided into two groups (n = 40). Percutaneous nephrolithotomy (MPCNL) and transurethral ureteroscopic lithotripsy The duration of operation and hospital stay were observed. The patients were followed up for 1 month. The rates of stone removal and complications were observed after 1 week and 1 month of treatment. Results The stone clearance rate of percutaneous nephrolithotomy group was 100% at 1 week and 1 month after operation, which was significantly higher than that of transurethral ureteroscopy group (70% and 87.5%, P <0.05) The operation time and hospital stay time of the group of renal nephrostomy were 62.87 ± 3.22min and 4.38 ± 1.01d, respectively, which were significantly different from that of transurethral ureteroscopy (P <0.05). No significant difference was found in complication rates of postoperative infection, fever, delayed hemorrhage and abdominal viscera injury between the two groups (P> 0.05). Conclusion Percutaneous nephrolithotomy lithotripsy for the treatment of upper ureteral incarcerated stones has obvious curative effect, high safety, reliable method and can be widely used in primary hospitals.