中国医师进修杂志
中國醫師進脩雜誌
중국의사진수잡지
CHINESE JOURNAL OF POSTGRADUATES OF MEDICINE
2010年
32期
20-22
,共3页
叶友新%邢金春%周中泉%陈实新%刘荣福%陈斌
葉友新%邢金春%週中泉%陳實新%劉榮福%陳斌
협우신%형금춘%주중천%진실신%류영복%진빈
输尿管结石%输尿管镜检查%逆行经尿道入路%顺行经皮肾微造瘘
輸尿管結石%輸尿管鏡檢查%逆行經尿道入路%順行經皮腎微造瘺
수뇨관결석%수뇨관경검사%역행경뇨도입로%순행경피신미조루
Ureteral calculi%Ureteroscopy%Retrograde transurethral access%Antegrade percutaneous nephrostomy tract
目的 比较顺行与逆行输尿管镜技术处理输尿管上段嵌顿性结石的疗效,并对其安全性与有效性进行评价.方法 采用输尿管镜技术共治疗输尿管上段嵌顿性结石106例,其中顺行经皮肾微造瘘入路50例(顺行组),逆行经尿道入路56例(逆行组).结果 逆行组手术成功52例(92.9%),手术时间(45±5)min,住院时间(6±1)d,一期结石清除率80.4%(45/56),7例需体外冲击波碎石术(ESWL)辅助治疗,出现手术并发症3例(5.4%);顺行组手术成功50例(100.0%),手术时间(55±8)min,住院时间(8±2)d,一期结石清除率100.0%(50/50),无手术并发症发生.两组一期结石清除率和并发症发生率比较差异有统计学意义(P＜0.05).结论 顺行与逆行输尿管镜技术处理输尿管上段嵌顿性结石均有较高的手术成功率,顺行入路的安全性与有效性更好,但手术时间及住院时间稍长.
目的 比較順行與逆行輸尿管鏡技術處理輸尿管上段嵌頓性結石的療效,併對其安全性與有效性進行評價.方法 採用輸尿管鏡技術共治療輸尿管上段嵌頓性結石106例,其中順行經皮腎微造瘺入路50例(順行組),逆行經尿道入路56例(逆行組).結果 逆行組手術成功52例(92.9%),手術時間(45±5)min,住院時間(6±1)d,一期結石清除率80.4%(45/56),7例需體外遲擊波碎石術(ESWL)輔助治療,齣現手術併髮癥3例(5.4%);順行組手術成功50例(100.0%),手術時間(55±8)min,住院時間(8±2)d,一期結石清除率100.0%(50/50),無手術併髮癥髮生.兩組一期結石清除率和併髮癥髮生率比較差異有統計學意義(P＜0.05).結論 順行與逆行輸尿管鏡技術處理輸尿管上段嵌頓性結石均有較高的手術成功率,順行入路的安全性與有效性更好,但手術時間及住院時間稍長.
목적 비교순행여역행수뇨관경기술처리수뇨관상단감돈성결석적료효,병대기안전성여유효성진행평개.방법 채용수뇨관경기술공치료수뇨관상단감돈성결석106례,기중순행경피신미조루입로50례(순행조),역행경뇨도입로56례(역행조).결과 역행조수술성공52례(92.9%),수술시간(45±5)min,주원시간(6±1)d,일기결석청제솔80.4%(45/56),7례수체외충격파쇄석술(ESWL)보조치료,출현수술병발증3례(5.4%);순행조수술성공50례(100.0%),수술시간(55±8)min,주원시간(8±2)d,일기결석청제솔100.0%(50/50),무수술병발증발생.량조일기결석청제솔화병발증발생솔비교차이유통계학의의(P＜0.05).결론 순행여역행수뇨관경기술처리수뇨관상단감돈성결석균유교고적수술성공솔,순행입로적안전성여유효성경호,단수술시간급주원시간초장.
Objective To compare the outcomes of antegrade and retrograde approach ureteroscopy for impacted upper ureteric calculi and assess the safety and efficiency of the two types of minimally invasive technique. Methods A total of 106 patients with impacted upper ureteric calculi were treated with ureteroscopy. The procedure was performed via antegrade percutaneous nephrostomy tract in 50 patients (antegrade group) and via retrograde transurethral access in 56 patients (retrograde group). Results The success rate of retrograde group was 92.9% (52/56). Operating time was (45 ± 5 ) min, hospital stay was (6 ± 1) days. The stone free rate was 80.4%(45/56) at 1 month follow-up,7 patients with residual calculi required ESWL combination. Complication rate was 5.4% (3/56). The success rate of antegrade group was 100.0% (50/50). Operating time was (55 ± 8 ) min, hospital stay was (8 ± 2) days. The stone free rate was 100.0% (50/50) and no complication was noted. The stone free rate and the complication rate indicated significant difference between the two groups (P ＜ 0.05). Conclusions Antegrade and retrograde access ureteroscopy for impacted upper ureteric calculi are safe and effective. Success rate and stone free rate of antegrade approach are higher than those of retrograde approach.
