摘要
目的评估后腹腔镜输尿管切开取石术(RLU)与微创经皮输尿管镜钬激光碎石取石术(MPCUL)治疗直径>1 cm,结石≤3枚;3.5 cm<结石距肾盂输尿管连接处(UPJ)<6.5 cm的复杂性输尿管上段结石的疗效。方法 2010年1月至2012年12月间,于1573例来兰州军区兰州总医院门诊就诊的输尿管结石患者中,按纳入标准和排除标准选择206例复杂性输尿管上段结石患者,以前瞻性随机对照研究方法分为RLU及MPCUL治疗组,每组103例记录两组患者术前一般资料,两组患者首次手术时间、总治疗时间、结石一次性排出或取净率、并发症发生率、总治疗费用、效率商(EQ值)及患肾肾小球滤过率(GFR)恢复等方面进行统计学分析。结果两组术前一般资料无明显统计学差异。RLU组首次手术时间为(90±15)min,总治疗时间20.4 d,结石一次性排出或取净率97.1%,并发症发生率6.8%,总治疗费用(1.8±0.7)万元,EQ值93.5%,术后3、6、9、12个月患肾GFR(27.5±1.5)、(41.6±1.7)、(49.6±1.3)、(53.1±0.8)ml/min,而MPCUL组分别为(50±10)min,19.4 d,92.2%,13.6%,(2.5±0.6)万元,84.8%,(23.6±1.1)、(31.1±1.4)、(38.7±1.7)、(43.5±1.5)ml/min。两组疗效差异均有统计学意义(P<0.05)。结论对于复杂性输尿管上段结石,RLU治疗优于MPCUL。
Objective To evaluate the efficacy of the retroperitoneal laparoscopic ureterolithotomy （RLU） and the minimally invasive percutaneous ureteroscopic lithotripsy （MPCUL） treatment of complex upper ureteral stones with its cliameter 〉1 cm,number ≤3,distance of ureterpelvic junction between 3.5-6.5 cm.Methods From January 2010 to December 2012,206 patients with complex upper ureteral stones were selected from 1,573 cases in patients with ureteral stones according to standard outpatient unified inclusion and exclusion criteria.They were divided into MPCUL and RLU treatment groups with 103 patients in each group,according to the method of prospective randomized controlled trial.119 cases of male,87 of female.Aged from 21 to 63,average 42.Statistical analysis were given to the two groups on preoperative parameters,the first operation time,total treatment time,the rate of disposable discharged stones and stones of one-time taken-out,the complication rate,the total cost of treatment,the efficiency quotient （EQ）,the recovery of one-side diseased kidney glomerular filtration rate （GFR）,and so on.Results No significant differences in preoperative parameters were observed between the two groups.For Group RLU,the first operation time was （90±15） min,the total treatment time was 20.4 d,the rate of disposable discharged stones and stones of one-time taken-out was 97.1%,the complication rate was 6.8%,the total cost of treatment was （1.8±0.7） ten thousand yuan,EQ value was 93.5%,one-side diseased kidney GFR （27.5± 1.5）,（41.6±1.7）,（49.6±1.3）,（53.1±0.8） ml/min,respectively 3,6,9,12 months after operation.For Group MPCUL,were （50±10） min,19.4 d,92.2%,13.6%,（2.5±0.6） ten thousand yuan,84.8%,（23.6±1.1）,（31.1± 1.4）,（38.7±1.7）,（43.5±1.5） ml/min respectively.Differences between the two groups were significant （P〈0.05）.Conclusion For complex proximal ureteral calculi,RLU therapy was superior to MPCUL.
出处
《中华腔镜泌尿外科杂志（电子版）》
2014年第6期23-27,共5页
Chinese Journal of Endourology(Electronic Edition)
基金
2011年全军医学科技"十二五"科研项目(CLZ12J004)
关键词
复杂性
输尿管
结石
后腹腔镜
微创
Complex, upper ureteral, calculi
Retroperitonescopy
Minimally invasive
