中国医师进修杂志
中國醫師進脩雜誌
중국의사진수잡지
CHINESE JOURNAL OF POSTGRADUATES OF MEDICINE
2015年
5期
332-335
,共4页
输尿管结石%肾造口术,经皮%钬%斜仰卧位
輸尿管結石%腎造口術,經皮%鈥%斜仰臥位
수뇨관결석%신조구술,경피%화%사앙와위
Ureteral calculi%Nephrostomy,percutaneous%Holmium%Oblique supine position
目的 比较输尿管硬镜钬激光(URS)和斜仰卧位微创经皮肾镜取石术(MPCNL)治疗输尿管中上段结石的疗效.方法 选取输尿管中上段结石患者96例,按就诊先后顺序分为URS组54例和MPCNL组42例,观察两组患者手术时间、术后住院时间、结石清除率、术中出血＞400 ml、术中中转开放手术、并发症发生率(包括术后发热),并分析结石成分.结果 URS组和MPCNL组手术时间分别为(55.3±12.1),(49.6±11.5) min;术后住院时间分别为(1.7±0.9),(4.4±1.2)d,差异有统计学意义(P＜ 0.05或＜0.01);URS组和MPCNL组患者结石清除率、并发症(Clavien分级Ⅱ级)发生率、术中中转开放手术率、术中出血＞400 ml率、并发症发生率及术后发热率比较差异均无统计学意义(P＞0.05);结石成分分析显示,草酸钙结石所占比例最大为51.0％(49/96).结论 URS和斜仰卧位MPCNL对于治疗输尿管中上段结石都是可以采用的安全有效方法,斜仰卧位MPCNL手术时间短,URS术后患者恢复快.
目的 比較輸尿管硬鏡鈥激光(URS)和斜仰臥位微創經皮腎鏡取石術(MPCNL)治療輸尿管中上段結石的療效.方法 選取輸尿管中上段結石患者96例,按就診先後順序分為URS組54例和MPCNL組42例,觀察兩組患者手術時間、術後住院時間、結石清除率、術中齣血＞400 ml、術中中轉開放手術、併髮癥髮生率(包括術後髮熱),併分析結石成分.結果 URS組和MPCNL組手術時間分彆為(55.3±12.1),(49.6±11.5) min;術後住院時間分彆為(1.7±0.9),(4.4±1.2)d,差異有統計學意義(P＜ 0.05或＜0.01);URS組和MPCNL組患者結石清除率、併髮癥(Clavien分級Ⅱ級)髮生率、術中中轉開放手術率、術中齣血＞400 ml率、併髮癥髮生率及術後髮熱率比較差異均無統計學意義(P＞0.05);結石成分分析顯示,草痠鈣結石所佔比例最大為51.0％(49/96).結論 URS和斜仰臥位MPCNL對于治療輸尿管中上段結石都是可以採用的安全有效方法,斜仰臥位MPCNL手術時間短,URS術後患者恢複快.
목적 비교수뇨관경경화격광(URS)화사앙와위미창경피신경취석술(MPCNL)치료수뇨관중상단결석적료효.방법 선취수뇨관중상단결석환자96례,안취진선후순서분위URS조54례화MPCNL조42례,관찰량조환자수술시간、술후주원시간、결석청제솔、술중출혈＞400 ml、술중중전개방수술、병발증발생솔(포괄술후발열),병분석결석성분.결과 URS조화MPCNL조수술시간분별위(55.3±12.1),(49.6±11.5) min;술후주원시간분별위(1.7±0.9),(4.4±1.2)d,차이유통계학의의(P＜ 0.05혹＜0.01);URS조화MPCNL조환자결석청제솔、병발증(Clavien분급Ⅱ급)발생솔、술중중전개방수술솔、술중출혈＞400 ml솔、병발증발생솔급술후발열솔비교차이균무통계학의의(P＞0.05);결석성분분석현시,초산개결석소점비례최대위51.0％(49/96).결론 URS화사앙와위MPCNL대우치료수뇨관중상단결석도시가이채용적안전유효방법,사앙와위MPCNL수술시간단,URS술후환자회복쾌.
Objective To compare the efficacy between ureteroscope with holmium laser lithotripsy (URS) and minimally invasive percutaneous nephrolithotomy (MPCNL) in oblique supine position for the proximal and middle ureteral calculi.Methods Ninety-six patients with proximal and middle ureteral calculi were divided into URS group (54 cases) and MPCNL group(42 cases) according to the treatment order.The operative duration,postoperative hospital stay,stone-free rate,intraoperative blood loss ＞ 400 ml rate,conversion to open surgery rate,complication rate including postoperative fever were observed,and stone composition was analyzed.Results The operative duration and postoperative hospital stay in URS group and MPCNL group were (55.3 ± 12.1),(49.6 ± 11.5) min and (1.7 ± 0.9),(4.4 ± 1.2) d,respectively,and there were significant differences (P ＜ 0.05 or ＜ 0.01).There were no significant differences in the stone-free rate,complication rate (Clavien degree Ⅱ),conversion to open surgery rate,intraoperative blood loss ＞ 400 ml rate,complication rate,postoperative fever rate (P ＞ 0.05).Stone composition analysis showed that the proportion of calcium oxalate stone was 51.0％(49/96).Conclusions URS and MPCNL in oblique supine position for the proximal and middle ureteral calculi are effective and safe therapeutic modalities.The operative duration of MPCNL in oblique supine position is shorter,and postoperative recovery of URS is fast.
