摘要
目的:比较输尿管镜碎石术(URL)、输尿管软镜碎石术(FURL)和后腹腔镜输尿管切开取石术(RLU)治疗单侧输尿管上段>10mm结石的临床疗效。方法:50例输尿管上段结石患者分成三组(URL组21例,FURL组19例,RLU组10例),比较分析组间术后肛门排气时间、住院时间、治疗费用、并发症发生率、结石清除率、术前和术后免疫学指标变化。结果:RLU组结石清除率(100%),优于URL组(81.0%)和FURL组(89.0%),URL组术后排气时间、住院时间最短,治疗费用最少,FURL组其次,RLU组最多。三组手术前后免疫球蛋白值、血红蛋白的改变差异无统计学意义。RLU组术后C反应蛋白(CRP)上升明显。结论:RLU具有一次手术结石清除率高的优点,输尿管镜碎石术无手术切口,术后恢复快,费用低。各术式对机体免疫影响相似。
Objective： To compare the effect among ureteroscopic lithotripsy （URL）, flexible ureteroscopic lithotripsy （FURL） and retroperitoneal laparoscopic ureterolithotomy （RLU） for upper ureteral calculi with more than 10 mm diameter. Method： A total of 50 patients had been enrolled in the study. Twenty-one patients received URL, 19 patients received FURL, and 10 patients received RLU. The efficacy and complications among three groups were compared retrospectively. Result： Comparison among three groups included the following： the clearance rate was 100% （RLU） vs. 81% （URL） vs. 89% （FURL）. Postoperative hospitalization time, passage of gas by anus time, cost listed URL, FURL, and RLU from small to large order. No statistical significance has been found among data of IgA, IgM, IgG, CD4/CD8, Hb pre/postoperative changes. Conclusion： RLU claims highest clearance rate of ureteral calculi, while URL and FURL have earlier postoperative hospitalization time, passage time of gas by anus and lower cost. There was no difference of the immune function influence among three groups.
作者
张青川
顾牣赜
何春锋
薛松
余万均
ZHANG Qingchuan GU Renze HE Chunfeng XUE Song YU Wanjun(Department of Urology, Putuo Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, 200062, Chin)
出处
《临床泌尿外科杂志》
2017年第2期103-104,108,共3页
Journal of Clinical Urology
基金
上海市普陀区卫生系统自主创新项目/重点项目(编号B-179)
关键词
输尿管结石
腹腔镜
输尿管镜
碎石术
ureteral calculi
laparoscopy
ureteroscopy
lithotripsy
