中国基层医药
中國基層醫藥
중국기층의약
CHINESE JOURNAL OF PRIMARY MEDICINE AND PHARMACY
2014年
7期
1012-1013,1014
,共3页
输尿管结石%经皮肾镜取石术%输尿管切开取石术
輸尿管結石%經皮腎鏡取石術%輸尿管切開取石術
수뇨관결석%경피신경취석술%수뇨관절개취석술
Ureteral calculi%Prcutaneous nephrolithotomy%Laparoscopic ureterolithotomy
目的：观察经皮肾镜取石术（PCNL）与后腹腔镜下输尿管切开取石术（RLU）治疗复杂性输尿管上段结石的临床效果。方法回顾性分析52例复杂性输尿管上段结石患者临床资料，其中采用PCNL治疗23例（ PCNL组）和采用RLU治疗29例（ RLU组），比较两组手术时间、术后1周结石清除率、手术并发症等。结果52例手术全部成功。手术时间：PCNL组[（45．12±11．56） min]短于RLU组[（82．03±12．45） min]（t＝10．13，P＜0．01）。术后1周结石清除率PCNL组为95．6％（22／23），RLU组100．0％（29／29），两组差异无统计学意义（P＞0．05）。术中、术后均无明显出血及周围脏器损伤等并发症。术后随访6～12个月，平均9个月，两组均未发现结石复发及输尿管狭窄。结论 PCNL与RLU治疗复杂性输尿管上段结石均是安全、有效的方法，可视患者具体情况、单位设备条件、术者经验酌情选择。
目的：觀察經皮腎鏡取石術（PCNL）與後腹腔鏡下輸尿管切開取石術（RLU）治療複雜性輸尿管上段結石的臨床效果。方法迴顧性分析52例複雜性輸尿管上段結石患者臨床資料，其中採用PCNL治療23例（ PCNL組）和採用RLU治療29例（ RLU組），比較兩組手術時間、術後1週結石清除率、手術併髮癥等。結果52例手術全部成功。手術時間：PCNL組[（45．12±11．56） min]短于RLU組[（82．03±12．45） min]（t＝10．13，P＜0．01）。術後1週結石清除率PCNL組為95．6％（22／23），RLU組100．0％（29／29），兩組差異無統計學意義（P＞0．05）。術中、術後均無明顯齣血及週圍髒器損傷等併髮癥。術後隨訪6～12箇月，平均9箇月，兩組均未髮現結石複髮及輸尿管狹窄。結論 PCNL與RLU治療複雜性輸尿管上段結石均是安全、有效的方法，可視患者具體情況、單位設備條件、術者經驗酌情選擇。
목적：관찰경피신경취석술（PCNL）여후복강경하수뇨관절개취석술（RLU）치료복잡성수뇨관상단결석적림상효과。방법회고성분석52례복잡성수뇨관상단결석환자림상자료，기중채용PCNL치료23례（ PCNL조）화채용RLU치료29례（ RLU조），비교량조수술시간、술후1주결석청제솔、수술병발증등。결과52례수술전부성공。수술시간：PCNL조[（45．12±11．56） min]단우RLU조[（82．03±12．45） min]（t＝10．13，P＜0．01）。술후1주결석청제솔PCNL조위95．6％（22／23），RLU조100．0％（29／29），량조차이무통계학의의（P＞0．05）。술중、술후균무명현출혈급주위장기손상등병발증。술후수방6～12개월，평균9개월，량조균미발현결석복발급수뇨관협착。결론 PCNL여RLU치료복잡성수뇨관상단결석균시안전、유효적방법，가시환자구체정황、단위설비조건、술자경험작정선택。
Objective To evaluate the effect of the percutaneous nephrolithotomy ( PCNL) in the manage-ment of complicated upper ureteric calculi , compared with retroperitoneal laparoscopic ureterolithotomy ( RLU ) . Methods Seventy-one cases with complicated upper ureteric calculi were retrospectively investigated ( PCNL group 23 cases,RLU group 29 cases).Clinical data including operation time ,stone free rate and the surgical complications were statistically analyzed .Results All the operations were successful in all 52 cases.Compared with the RLU group,the PCNL group had a significant shorter operation time [(45.12 ±11.56)min vs (82.03 ±12.45)min,t=10.13,P<0.01],and significant difference were detected .A week after the operation,the PCNL group showed a stone free rate of 95.6%(22/23) while the RLU group 100.0%(29/29),and no significant difference were detec-ted.No significant complications ,such as intraoperative or postoperative bleeding and damage to surrounding organs , were detected.The patients were followed up for 6 to 12 months(mean,9 months),and no recurrent stones or ureteral stricture were developed during the period .Conclusion Both PCNL and RLU are safe and effective for complicated upper ureteral calculi.The appropriate method depends on the patients′specific conditions,the unit equipments and the experience of operator .
