CAJ | 학술논문

目的探讨经皮肾镜超声碎石取石术与输尿管钬激光治疗输尿管上段结石的临床疗效.方法选取徐州医学院附属医院2012年12月-2014年10月收治的156例经B超及CT等影像学检查确诊为输尿管上段结石的患者作为研究对象.将156例患者按入院时住院号的末尾数字的单双号随机分为2组,对照组实施输尿管钬激光碎石术治疗,治疗组采用微创经皮肾镜碎石术治疗,观察并比较两组治疗效果,结石清除率,术后恢复以及并发症发生情况.结果经皮肾镜组与输尿管钬激光组相比,手术时间分别为(28.6±7.4)min、(43.4±12.4) min,住院时间分别为(7.5±1.0)d、(4.2±1.3)d,手术成功率分别为100％、93.4％,结石清除率分别为100％、85.5％,残石率分别为0％、15.7％,差异均有统计学意义(p＜0.05).经皮肾镜组并发症发病率明显低于输尿管钬激光组(P＜0.05).术后发热发病率,两组分别为15％、6％,差异无统计学差异(P＞0.05).结论结石较小及离肾盂输尿管连接部较远时,建议采用输尿管钬激光碎石术;较大的输尿管上段结石及肾盂输尿管连接部结石建议采用经皮肾镜超声碎石取石术治疗.
목적 탐토경피신경초성쇄석취석술여수뇨관화격광치료수뇨관상단결석적림상료효.방법 선취서주의학원부속의원2012년12월-2014년10월수치적156례경B초급CT등영상학검사학진위수뇨관상단결석적환자작위연구대상.장156례환자안입원시주원호적말미수자적단쌍호수궤분위2조,대조조실시수뇨관화격광쇄석술치료,치료조채용미창경피신경쇄석술치료,관찰병비교량조치료효과,결석청제솔,술후회복이급병발증발생정황.결과 경피신경조여수뇨관화격광조상비,수술시간분별위(28.6±7.4)min、(43.4±12.4) min,주원시간분별위(7.5±1.0)d、(4.2±1.3)d,수술성공솔분별위100％、93.4％,결석청제솔분별위100％、85.5％,잔석솔분별위0％、15.7％,차이균유통계학의의(p＜0.05).경피신경조병발증발병솔명현저우수뇨관화격광조(P＜0.05).술후발열발병솔,량조분별위15％、6％,차이무통계학차이(P＞0.05).결론 결석교소급리신우수뇨관련접부교원시,건의채용수뇨관화격광쇄석술;교대적수뇨관상단결석급신우수뇨관련접부결석건의채용경피신경초성쇄석취석술치료.
Objective To compare the clinical efficacy of percutaneous nephrolithotomy and holmium laser lithotripsy in the treatment of proximal ureteral stones.Methods One hundred and fifty-six patients with ureteral calculi diagnosed by B ultrasound,CT or other imaging were selected as research subjects in the Affiliated Hospital of Xuzhou Medical College from Dec.2012 to Oct.2014.All patients were randomly divided in to two groups according to the odd and even numbers at the last digit of the admission hospital number,of the control group conducted the ureter holmium laser lithotripsy and the treatment group conducted to minimally invasive percutaneous nephrolithotomy,observed and compared two groups therapeutic effect,stone clearance rate,postoperative recovery and complications.Results For the percutaneous nephrolithotomy group,operation time was (28.6 ± 7.4) minutes,hospitalization time was (7.5 ± 1.0)days,the rate of success of operation was 100,stones clearance rate was 100％,the residual stone rate was 0;For the holmium laser lithotripsy group,operation time was (43.4 ± 12.4) minutes,hospitalization time was (4.2 ± 1.3) days,the rate of success of operation was 93.4％,stones clearance rate was 85.5％,the residual stone rate was 15.7％.Compared with the holmium laser lithotripsy group,the percutaneous nephrolithotomy group had higher rate of success of operation,stones clearance rate and lower operation time,residual stone rate and complications.But hospitalization time was longer.Conclusions For smaller stones,holmium laser lithotripsy is better rather than percutaneous nephrolithotomy group.However,for larger stones,percutaneous nephrolithotomy operation is better than laser lithotripsy operation.