CAJ | 학술논문

目的探讨经皮肾镜与腹腔镜治疗输尿管上段结石的临床疗效.方法回顾和分析本院自2011年1月～2013年3月收治的输尿管上段结石患者共74例,其中经皮肾镜组39例、腹腔镜组35例,对比研究两组患者各项临床疗效指标.结果经皮肾镜组一次性清石率为92.31％,术后并发症发生率为12.82％,腹腔镜组一次性清石率为94.29％,术后并发症发生率为11.43％,两组患者一次性清石率、术后并发症发生率无统计学差异(P＞0.05).腹腔镜组手术时间较经皮肾镜组长,而术后卧床时间、平均住院时间、术中出血量少于经皮肾镜组,差异有统计学意义(P＜0.05).结论经皮肾镜与腹腔镜技术治疗输尿管上段结石安全、有效.对多发性输尿管上段结石,经皮肾镜技术效果确切;腹腔镜不受输尿管通畅性影响,术中出血量少,对肾积水较轻、嵌顿时间长、单一较大输尿管上段结石可作为优先选择.临床可根据具体情况选择合适的手术方法提高患者手术清石率、降低手术并发症.
목적 탐토경피신경여복강경치료수뇨관상단결석적림상료효.방법 회고화분석본원자2011년1월～2013년3월수치적수뇨관상단결석환자공74례,기중경피신경조39례、복강경조35례,대비연구량조환자각항림상료효지표.결과 경피신경조일차성청석솔위92.31％,술후병발증발생솔위12.82％,복강경조일차성청석솔위94.29％,술후병발증발생솔위11.43％,량조환자일차성청석솔、술후병발증발생솔무통계학차이(P＞0.05).복강경조수술시간교경피신경조장,이술후와상시간、평균주원시간、술중출혈량소우경피신경조,차이유통계학의의(P＜0.05).결론 경피신경여복강경기술치료수뇨관상단결석안전、유효.대다발성수뇨관상단결석,경피신경기술효과학절;복강경불수수뇨관통창성영향,술중출혈량소,대신적수교경、감돈시간장、단일교대수뇨관상단결석가작위우선선택.림상가근거구체정황선택합괄적수술방법제고환자수술청석솔、강저수술병발증.
Objectives To investigate the clinical results of percutaneous nephrolithotomy and laparoscopic treatment of ureteral calculi.Methods 74 cases of ureteral calculi were divided into percutaneous nephrolithotomy treatment group(n =39) and laparoscopic treatment group(n =35) from Jan 2011 to Mar 2013.The relevant factors of clinical outcomes were alaysized.Results The rate of Percutaneous nephrolithotomy group 1 (92.31％ vs 94.29％) and postoperative complication(12.82％ vs 11.43％) of percutaneous nephrolithotomy were not statistically significant (P ＞ 0.05) than laparoscopic treatment group.The percutaneous nephrolithotomy time of laparoscopic treatment group was longer than percutaneous nephrolithotomy treatment group.The bed time,the average length of hospital stay,less blood of laparoscopic treatment group were loss than percutaneous nephrolithotomy treatment group (P ＜ 0.05).Conclusions Percutaneous nephrolithotomy and laparoscopic treatment of ureteral calculi are safe and effective surgical method,For multiple ureteral calculi,percutaneous nephroscope technical effect exactly ; Laparoscopy is not affected by ureteral smooth sex,intraoperative blood loss,less on kidney seeper is lighter,a single large ureteral calculi can be used as a preferred choice.Clinical according to the specific situation to choose the appropriate.