CAJ | 학술논문

目的：比较分析输尿管镜碎石取石术与后腹腔镜输尿管切开取石术治疗单侧输尿管上段结石的临床疗效。方法选取2010年1月至2012年7月期间于该院接受诊断和治疗的单侧输尿管上段结石患者126例，根据手术方式不同分为腹腔镜组和输尿管镜组，每组63例。输尿管镜组患者给予全麻下输尿管镜碎石取石术治疗，腹腔镜组患者给予全麻下后腹腔镜输尿管切开取石术治疗。比较两组患者手术时间、结石清除率、术后镇痛泵使用时间，分析两种治疗方式的临床疗效。结果输尿管镜组患者手术时间显著低于腹腔镜组，结石清除率显著高于腹腔镜组，比较结果均具有统计学意义（P＜0．05）；两组患者住院时间和手术后镇痛泵使用时间比较结果无统计学意义（P＞0．05）；两组患者手术并发症发生状况比较结果无统计学意义（P＞0．05）。结论输尿管镜碎石取石术与后腹腔镜输尿管切开取石术两种手术方式在治疗单侧输尿管上段结石方面均具有较好的临床疗效，均能显著降低患者手术并发症的发生，而后者具有手术时间短、结石清除率高等优势，值得在临床推广使用。
목적：비교분석수뇨관경쇄석취석술여후복강경수뇨관절개취석술치료단측수뇨관상단결석적림상료효。방법선취2010년1월지2012년7월기간우해원접수진단화치료적단측수뇨관상단결석환자126례，근거수술방식불동분위복강경조화수뇨관경조，매조63례。수뇨관경조환자급여전마하수뇨관경쇄석취석술치료，복강경조환자급여전마하후복강경수뇨관절개취석술치료。비교량조환자수술시간、결석청제솔、술후진통빙사용시간，분석량충치료방식적림상료효。결과수뇨관경조환자수술시간현저저우복강경조，결석청제솔현저고우복강경조，비교결과균구유통계학의의（P＜0．05）；량조환자주원시간화수술후진통빙사용시간비교결과무통계학의의（P＞0．05）；량조환자수술병발증발생상황비교결과무통계학의의（P＞0．05）。결론수뇨관경쇄석취석술여후복강경수뇨관절개취석술량충수술방식재치료단측수뇨관상단결석방면균구유교호적림상료효，균능현저강저환자수술병발증적발생，이후자구유수술시간단、결석청제솔고등우세，치득재림상추엄사용。
Objective To compare the clinical effects of ureteroscopic lithotripsy stone surgery and retroperitoneal laparoscopic uret-erolithotomy in treatment of unilateral ureteral calculus.Methods 126 cases of patients with unilateral ureteral calculi in January 2010 to July 2012 in our hospital for diagnosis and treatment were randomly divided into observation group and control group of 63 cases.The control group was treated with ureteroscopic lithotripsy during lumbar epidural anesthesia for treatment while the observation group was treated with laparoscopic ureterolithotomy under general anesthesia.The operation time,stone free rate,analgesic pump use the time af-ter the operation were compared of two groups,to analyze the clinical effect of two kinds of treatment.Results The operation time of the observation group was significantly lower than that of the control group,the stone free rate was significantly higher than that of the control group,the difference was statistically significant (P<0.05);The hospitalization time and the using time of analgesia pump after operation in the two group had no statistically significant difference ( P>0.05); The complication after operation of the two groups had no statistically significant ( P >0 .05 ) .Conclusion Ureteroscopic lithotripsy and retroperitoneal laparoscopic uret-erolithotomy have good clinical efficacy in treatment of unilateral ureteral calculi,which can significantly reduce complications after operation,while the latter has advantages on short operation time,stone clearance rate and so on,it is worthy of clinical application.