摘要
目的比较经尿道输尿管硬镜下钬激光碎石术(URL)、经尿道输尿管软镜下钬激光碎石术(FURS)、经皮肾镜钬激光碎石取石术(PCNL)三种微创方法治疗复杂性输尿管上段结石的疗效以及安全性。方法回顾分析2016年1月至2018年12月芜湖市第二人民医院泌尿外科收治的复杂性输尿管上段结石患者60例的临床资料,按治疗方法将其分为URL组(20例)、FURS组(20)和PCNL组(20例),观察比较三组结石清除率、手术时间、术中出血量、术后出血量、住院时间等。结果URL组一次性碎石成功率明显低于FURS组和PCNL组(FURS比URL:χ^2=5.83,P<0.05,URL比PCNL:χ^2=8.03,P<0.05);URL组和FURS组手术时间(FURS比PCNL:t=2.436,P<0.05,URL比PCNL:t=2.634,P<0.05)、住院时间及术中、术后出血明显少于PCNL组(FURS比PCNL:t=2.243,P<0.05,URL比PCNL:t=2.320,P<0.05),在术中、术后感染、发热及肾绞痛等并发症方面三组差异均无统计学意义(均P>0.05)。结论采用FURS治疗复杂性输尿管上段结石,一次性结石清除率优于URL术;与PCNL术相比,术中、术后患者出血量明显少于后者,并且手术时间和住院时间较PCNL术短。建议对复杂性输尿管上段结石的治疗优先考虑采用FURS术。
Objective To compare the efficacy and safety of three minimally invasive methods,transurethral rigid ureteroscopic holmium laser lithotripsy(URL),transurethral flexible ureteroscopic holmium laser lithotripsy(FURS),and percutaneous nephroscopic holmium laser lithotripsy(PCNL),in the treatment of complicated upper ureteral calculi.Methods The clinical data of 60 patients with complex upper ureteral calculi admitted to the urology department of the Second People's Hospital of Wuhu from January 2016 to December 2018 were retrospectively analyzed.All patients were divided into three groups according to treatment methods:URL group(20 cases),FURS group(20 cases)and PCNL group(20 cases).The efficacy of the three methods was compared in terms of stone removal rate,operation time,intraoperative and postoperative bleeding,length of hospital stay and other indicators.Results The success rate of one-time lithotripsy in the URL group was significantly lower than that in the FURS group and the PCNL group(FURS vs.URL,χ^2=5.83,P<0.05,URL vs.PCNL,χ^2=8.03,P<0.05).The operative time(FURS vs.PCNL,t=2.436,P<0.05,URL vs.PCNL,t=2.634,P<0.05),hospital stay,intraoperative and postoperative bleeding in the URL group and FURS group were significantly less than those in the PCNL group(FURS vs.PCNL,t=2.243,P<0.05,URL vs.PCNL,t=2.320,P<0.05).There were no statistically significant differences among intraoperative,postoperative infection,fever,renal colic and other complications(all P>0.05).Conclusion FURS in the treatment of complicated upper ureteral calculi,the one-time stone removal rate is better than URL operation,compared with PCNL,the intraoperative and postoperative bleeding is significantly less than the latter,and the operative time and hospital stay are shorter than PCNL.It is suggested that FURS operation should be given priority in the treatment of complicated upper ureteral calculi.
作者
石结武
陶凌松
徐磊
丁维
Shi Jiewu;Tao Lingsong;Xu Lei;Ding Wei(Department of Urology,the Second People's Hospital of Wuhu,Wuhu,Anhui 241000,China)
出处
《中国基层医药》
CAS
2020年第11期1294-1298,共5页
Chinese Journal of Primary Medicine and Pharmacy
关键词
输尿管结石症
输尿管硬镜下钬激光碎石术
输尿管软镜下钬激光碎石术
经皮肾镜钬激光碎石取石术
一次性结石清除率
术中出血
手术时间
术后出血
Ureterolithiasis
Ureteroscopic holmium laser lithotripsy
Flexible ureteroscope holmium laser lithotripsy
Percutaneous nephroscopic holmium laser lithotripsy
One-time stone clearance rate
Intraoperative bleeding
Operative time
Postoperative bleeding
