中国微创外科杂志
中國微創外科雜誌
중국미창외과잡지
CHINESE JOURNAL OF MINIMALLY INVASIVE SURGERY
2014年
7期
631-633
,共3页
李应忠%王健%佟发春%翟成喜
李應忠%王健%佟髮春%翟成喜
리응충%왕건%동발춘%적성희
输尿管上段结石%输尿管镜%经皮肾镜碎石术
輸尿管上段結石%輸尿管鏡%經皮腎鏡碎石術
수뇨관상단결석%수뇨관경%경피신경쇄석술
Ureteral calculus%Ureterscope%Percutaneous nephrolithotomy
目的：比较微创经皮肾镜碎石术（minimally invasive percutaneous nephrolithotomy ，MPCNL）与输尿管镜碎石术（ ureteroscopic lithotripsy ，URL）治疗嵌顿性输尿管上段结石的疗效和安全性。方法回顾性分析2007年6月～2013年6月226例嵌顿性输尿管上段结石的临床资料，其中116例采用MPCNL治疗，110例采用URL治疗，比较两组结石清除率、手术时间、并发症发生率。结果 MPCNL组术后3 d结石清除率96．6％（112/116），1个月后的结石清除率为99．1％（115/116）。URL组术后3 d结石清除率为47．3％（52/110），49例残留结石＞0．4 cm，接受ESWL 治疗，1个月后结石清除率为83．6％（92/110）。结石清除率MPCNL组高于URL组（χ2＝68．873、17．619，P均＝0．000）。2组手术时间以及出血＞400 ml、发热和肾绞痛等并发症发生率差异无显著性（ P＞0．05）。结论 MPCNL治疗嵌顿性输尿管上段结石有很高的结石清除率；URL治疗效果稍差，而且需要结合ESWL治疗才能提高疗效。 MPCNL可作为嵌顿性输尿管上段结石的首选治疗方法。
目的：比較微創經皮腎鏡碎石術（minimally invasive percutaneous nephrolithotomy ，MPCNL）與輸尿管鏡碎石術（ ureteroscopic lithotripsy ，URL）治療嵌頓性輸尿管上段結石的療效和安全性。方法迴顧性分析2007年6月～2013年6月226例嵌頓性輸尿管上段結石的臨床資料，其中116例採用MPCNL治療，110例採用URL治療，比較兩組結石清除率、手術時間、併髮癥髮生率。結果 MPCNL組術後3 d結石清除率96．6％（112/116），1箇月後的結石清除率為99．1％（115/116）。URL組術後3 d結石清除率為47．3％（52/110），49例殘留結石＞0．4 cm，接受ESWL 治療，1箇月後結石清除率為83．6％（92/110）。結石清除率MPCNL組高于URL組（χ2＝68．873、17．619，P均＝0．000）。2組手術時間以及齣血＞400 ml、髮熱和腎絞痛等併髮癥髮生率差異無顯著性（ P＞0．05）。結論 MPCNL治療嵌頓性輸尿管上段結石有很高的結石清除率；URL治療效果稍差，而且需要結閤ESWL治療纔能提高療效。 MPCNL可作為嵌頓性輸尿管上段結石的首選治療方法。
목적：비교미창경피신경쇄석술（minimally invasive percutaneous nephrolithotomy ，MPCNL）여수뇨관경쇄석술（ ureteroscopic lithotripsy ，URL）치료감돈성수뇨관상단결석적료효화안전성。방법회고성분석2007년6월～2013년6월226례감돈성수뇨관상단결석적림상자료，기중116례채용MPCNL치료，110례채용URL치료，비교량조결석청제솔、수술시간、병발증발생솔。결과 MPCNL조술후3 d결석청제솔96．6％（112/116），1개월후적결석청제솔위99．1％（115/116）。URL조술후3 d결석청제솔위47．3％（52/110），49례잔류결석＞0．4 cm，접수ESWL 치료，1개월후결석청제솔위83．6％（92/110）。결석청제솔MPCNL조고우URL조（χ2＝68．873、17．619，P균＝0．000）。2조수술시간이급출혈＞400 ml、발열화신교통등병발증발생솔차이무현저성（ P＞0．05）。결론 MPCNL치료감돈성수뇨관상단결석유흔고적결석청제솔；URL치료효과초차，이차수요결합ESWL치료재능제고료효。 MPCNL가작위감돈성수뇨관상단결석적수선치료방법。
Objective To compare the efficacy and safety of minimally invasive percutaneous nephrolithotomy ( MPCNL) with ureteroscopic lithotripsy ( URL) in the management of obstructive upper ureteral calculus . Methods Clinical data of 226 patients with ureteral calculus admitted into our hospital from June 2007 to June 2013 were retrospectively analyzed .Of them, 116 cases received MPCNL and 110 cases URL.The stone-free rate, operation time, postoperative complications were compared between the two groups, respectively. Results In the MPCNL group, the stone-free rate was 96.6%(112/116) in 3 days postoperation and 99.1%(115/116) in a month postoperation.In the URL group, the stone-free rate was 47.3% (52/110) in 3 days postoperation, with 49 patients having residual stones larger than 0.4 cm in diameter and thus receiving an EWSL .The stone-free rate was 83.6%(92/110) in a month postoperation in the URL group .The MPCNL group got a higher stone-free rate at both 3 days and 1 month postoperation compared with the URL group, with significant difference (χ2 =68.873 and 17.619, P =0.000).No significant difference was detected in the operation time, rate of blood loss more than 400 ml, fever, renal colic between the two groups (P >0.05). Conclusions Higher stone-free rate can be obtained with MPCNL than with URL for obstructive upper ureteral calculus .Performance of URL combined with auxiliary ESWL has satisfactory effects .The MPCNL should be the first choice for obstructive upper ureteral calculus.
