现代泌尿外科杂志
現代泌尿外科雜誌
현대비뇨외과잡지
JOURNAL OF MODERN UROLOGY
2015年
4期
237-240
,共4页
输尿管结石%输尿管镜%钬激光%微创经皮肾穿刺取石术
輸尿管結石%輸尿管鏡%鈥激光%微創經皮腎穿刺取石術
수뇨관결석%수뇨관경%화격광%미창경피신천자취석술
ureteral calculi%ureteroscopy%holmium laser%minimally invasive percutaneous nephrolithotomy(MPCNL)
目的：比较微创经皮肾穿刺取石术（MPCNL）和经尿道输尿管镜钬激光碎石术（URL）治疗输尿管上段结石的疗效。方法选取225例输尿管上段结石患者，其中MPCNL 组117例，URL组108例，分别采用对应方法治疗。比较两组手术时间、并发症、术后住院时间、术后需体外冲击波碎石术（ESWL ）治疗的例数、术后3 d和1个月结石清除率等。结果两组间手术时间及术后住院天数比较均有极显著性差异（MPCNL组＞URL组，P＜0．01）。两组间术后3 d及术后1个月的结石清除率比较差异有统计学意义（MPCNL组＞URL组，P＜0．05和 P＜0．01）。两组术后需行 ESWL治疗的例数及并发症发生率比较差异均无统计学意义（P＞0．05）。结论 MPCNL结石清除率高，但手术创伤相对较大，住院时间较长；URL操作简单，术后恢复快，但疗效较M PCNL稍差。临床医生应根据医院的设备条件及结石的位置、大小等不同情况选择适当的治疗方式。
目的：比較微創經皮腎穿刺取石術（MPCNL）和經尿道輸尿管鏡鈥激光碎石術（URL）治療輸尿管上段結石的療效。方法選取225例輸尿管上段結石患者，其中MPCNL 組117例，URL組108例，分彆採用對應方法治療。比較兩組手術時間、併髮癥、術後住院時間、術後需體外遲擊波碎石術（ESWL ）治療的例數、術後3 d和1箇月結石清除率等。結果兩組間手術時間及術後住院天數比較均有極顯著性差異（MPCNL組＞URL組，P＜0．01）。兩組間術後3 d及術後1箇月的結石清除率比較差異有統計學意義（MPCNL組＞URL組，P＜0．05和 P＜0．01）。兩組術後需行 ESWL治療的例數及併髮癥髮生率比較差異均無統計學意義（P＞0．05）。結論 MPCNL結石清除率高，但手術創傷相對較大，住院時間較長；URL操作簡單，術後恢複快，但療效較M PCNL稍差。臨床醫生應根據醫院的設備條件及結石的位置、大小等不同情況選擇適噹的治療方式。
목적：비교미창경피신천자취석술（MPCNL）화경뇨도수뇨관경화격광쇄석술（URL）치료수뇨관상단결석적료효。방법선취225례수뇨관상단결석환자，기중MPCNL 조117례，URL조108례，분별채용대응방법치료。비교량조수술시간、병발증、술후주원시간、술후수체외충격파쇄석술（ESWL ）치료적례수、술후3 d화1개월결석청제솔등。결과량조간수술시간급술후주원천수비교균유겁현저성차이（MPCNL조＞URL조，P＜0．01）。량조간술후3 d급술후1개월적결석청제솔비교차이유통계학의의（MPCNL조＞URL조，P＜0．05화 P＜0．01）。량조술후수행 ESWL치료적례수급병발증발생솔비교차이균무통계학의의（P＞0．05）。결론 MPCNL결석청제솔고，단수술창상상대교대，주원시간교장；URL조작간단，술후회복쾌，단료효교M PCNL초차。림상의생응근거의원적설비조건급결석적위치、대소등불동정황선택괄당적치료방식。
Objective To compare the clinical efficacy of minimally invasive percutaneous nephrolithotomy (MPCNL) and ureteroscopic holmium laser lithotripsy (URL) for the treatment of upper ureteral calculi .Methods A total of 225 pa-tients were enrolled in the study ,of whom 117 received MPCNL and 108 received URL .The operation time ,complications , postoperative hospitalization time ,rate of postoperative extracorporeal shock wave lithtripsy (ESWL) ,the stone-free rate in 3 days and 1 month after operation were compared between the two groups .Results The operation time and postoperative hospitalization time for the MPCNL group were longer than those for the URL group (both P<0 .01) .The stone-free rate in 3 days and 1 month after operation in the MPCNL group were higher than those in the URL group (P< 0 .05 , P< 0 .01) . There was no statistical difference between the two groups in rate of postoperative ESWL and incidence of complications (both P>0 .05) .Conclusions MPCNL produces higher calculi clearance rate ,but causes greater surgical trauma ,and needs longer hospitalization time .URL has advantages of simple operation and quick postoperative recovery ,but it may have inferior effi-cacy .The clinical physicians should select a suitable method according to hospital equipment ,calculi location and size .
