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目的:探讨后腹腔镜输尿管切开取石术(RLU)在治疗长径>1cm的复杂性输尿管上段结石中的优劣。方法:回顾2010年1月~2012年12月,103例长径>1cm的复杂性输尿管上段结石患者的临床资料,其中男61例,女42例。年龄21~63岁,平均41岁。对手术时间、结石一次性取尽率、并发症发生率、总治疗费用、效率商及患肾肾小球滤过率(GFR)恢复等方面进行统计学分析。结果:手术时间为(90±15)min;结石一次性取尽率97.1%;并发症发生率6.8%;总治疗费用(1.8±0.7)万元;效率商93.5%;术后6个月及12个月患肾GFR分别为(41.6±1.7)和(53.1±0.8)ml/min。结论:对于复杂性输尿管上段结石,当结石最大径>1.0cm、结石≤3枚、结石距肾盂输尿管交界处>3.5cm时RLU治疗效果好,但也有出现结石移位及输尿管狭窄等并发症的可能。
Objective: To investigate the advantages and disadvantages of retroperitoneal laparoscopic ureteral lithotomy (RLU) in the treatment of complicated upper ureteral calculi with long diameter> 1cm. Methods: From January 2010 to December 2012, 103 patients with complex ureteral calculi with a diameter of 1 cm were retrospectively analyzed, including 61 males and 42 females. Aged 21 to 63 years old, average 41 years old. The operation time, one-time stone exhaustion rate, complication rate, total treatment cost, efficiency quotient, and the recovery of renal glomerular filtration rate (GFR) were statistically analyzed. Results: The operation time was (90 ± 15) min, the rate of one-off stones was 97.1%, the complication rate was 6.8%, the total treatment cost was 1.8 ± 0.7 million, the effective rate was 93.5% GFR at 12 months was (41.6 ± 1.7) and (53.1 ± 0.8) ml / min, respectively. Conclusion: For the complicated upper ureteral calculi, when RLU> 1.0cm, stones ≤3, stones with RLU> 3.5cm at the junction of ureteropelvic junction, RLU is effective, but complications such as stone displacement and ureteral stricture may.