不同手術(shù)方式治療輸尿管結(jié)石的效果分析

茍險(xiǎn)峰

摘 要：目的 觀察分析三種不同手術(shù)方式治療輸尿管結(jié)石的效果。方法 選取本院2016年12月～2017年12月收治的210例輸尿管結(jié)石患者，按照數(shù)字隨機(jī)表法分為A、B、C三組，每組70例。A組應(yīng)用開(kāi)放性輸尿管切開(kāi)取石術(shù)，B組應(yīng)用體外沖擊波碎石術(shù)，C組應(yīng)用微創(chuàng)經(jīng)皮腎鏡鈥激光碎石取石術(shù)。采用統(tǒng)計(jì)學(xué)分析三組輸尿管結(jié)石患者的一次性成功率、術(shù)后結(jié)石完全清除率、平均住院時(shí)間、平均手術(shù)時(shí)間以及平均術(shù)中出血量、患者總滿意率。結(jié)果 C組患者的一次性成功率、術(shù)后結(jié)石完全清除率等臨床治療效果，高于A組、B組，差異有統(tǒng)計(jì)學(xué)意義（P<0.05），A組患者的平均手術(shù)時(shí)間、平均住院時(shí)間高于C組、B組，差異有統(tǒng)計(jì)學(xué)意義（P<0.05），B組平均術(shù)中出血量少于A組、C組，差異有統(tǒng)計(jì)學(xué)意義（P<0.05）；C組患者的總滿意率高于A組、B組，差異有統(tǒng)計(jì)學(xué)意義（P<0.05）。結(jié)論 微創(chuàng)經(jīng)皮腎鏡鈥激光碎石取石術(shù)治療輸尿管結(jié)石患者的臨床效果顯著高于體外沖擊波碎石術(shù)和開(kāi)放性輸尿管切開(kāi)取石術(shù)。

關(guān)鍵詞：微創(chuàng)經(jīng)皮腎鏡鈥激光碎石取石術(shù)；輸尿管結(jié)石；不同手術(shù)方式

中圖分類(lèi)號(hào)：R699.4 文獻(xiàn)標(biāo)識(shí)碼：A DOI：10.3969/j.issn.1006-1959.2018.17.028

文章編號(hào)：1006-1959（2018）17-0092-03

Abstract：Objective To observe the effect of three different surgical methods in the treatment of ureteral calculi.Methods A total of 210 patients with ureteral calculi admitted to our hospital from December 2016 to December 2017 were divided into three groups：A， B，and C according to the numerical random table method，70 cases in each group.Group A was treated with open ureterolithotomy， group B was treated with extracorporeal shock wave lithotripsy，and group C was treated with minimally invasive percutaneous nephrolithotomy with holmium laser lithotripsy.The one-time success rate，complete stone removal rate，average hospitalization time， average operation time，average intraoperative blood loss，and total patient satisfaction rate were analyzed by statistical analysis of three groups of patients with ureteral calculi.Results The clinical outcomes of group C patients with one-time success rate and complete postoperative stone removal rate were higher than those in group A and group B，the difference was statistically significant（P<0.05）.The average operation time and average hospitalization time of patients in group A were higher than those in group C and B，the difference was statistically significant（P<0.05）.The average intraoperative blood loss in group B was less than that in group A and C.The difference was statistically significant（P<0.05）；the total satisfaction rate of patients in group C was higher than that in group A and group B，the difference was statistically significant（P<0.05）.Conclusion The clinical outcome of minimally invasive percutaneous nephrolithotomy with holmium laser lithotripsy in the treatment of ureteral calculi is significantly higher than extracorporeal shock wave lithotripsy and open ureterolithotomy.

Key words：Minimally invasive percutaneous nephrolithotomy holmium laser lithotripsy；Ureteral calculi；Different surgical methods

腎、輸尿管結(jié)石（kidney andureter calculi）是一種臨床常見(jiàn)的泌尿系統(tǒng)疾病，輸尿管結(jié)石近年來(lái)發(fā)病率呈現(xiàn)逐年上升發(fā)展趨勢(shì)[1]。輸尿管結(jié)石長(zhǎng)時(shí)間嵌頓會(huì)損傷患者的輸尿管黏膜，最終給治療帶來(lái)較大挑戰(zhàn)[2]。輸尿管結(jié)石具有以下顯著臨床癥狀：①腎絞痛；②血尿[3]。由于輸尿管結(jié)石的位置較為特殊，因此必須根據(jù)其具體病情來(lái)選擇合適的手術(shù)方式。盡管治療輸尿管結(jié)石患者的手術(shù)方式越來(lái)越多，但是也有部分學(xué)者認(rèn)為微創(chuàng)手術(shù)方式治療效果不一，本文將2016年12月～2017年12月收治的210例輸尿管結(jié)石患者，觀察分析不同手術(shù)方式治療輸尿管結(jié)石的效果，現(xiàn)報(bào)道如下。

1資料與方法

1.1一般資料 選取攀枝花市中西醫(yī)結(jié)合醫(yī)院2016年12月～2017年12月收治的210例輸尿管結(jié)石患者。按照數(shù)字隨機(jī)表法分為三組，每組70例。……