微通道經皮腎鏡與后腹腔鏡治療嵌頓性輸尿管上段結石的臨床效果比較

嚴全華

[摘要]目的 探討微通道經皮腎鏡與后腹腔鏡治療嵌頓性輸尿管上段結石的臨床效果。方法 選取2017年1月～2018年3月我院收治的80例嵌頓性輸尿管上段結石患者作為研究對象，并按治療術式的不同將患者分為兩組，每組各40例。對照組患者采取后腹腔鏡手術取石術進行治療，研究組患者則采取微通道經皮腎鏡進行治療。比較兩組患者的手術時間、術中出血、結石取凈率、住院時間、術后疼痛視覺模擬評分（VAS）及并發癥發生情況。結果 研究組患者的手術時間、住院時間均短于對照組，術后24 h VAS評分低于對照組，差異有統計學意義（P<0.05），而兩組患者的術中出血量比較，差異無統計學意義（P>0.05）;研究組患者的結石取凈率（100.00%）高于對照組（90.00%），差異有統計學意義（P<0.05）;研究組患者的并發癥總發生率（5.00%）與對照組（7.50%）比較，差異無統計學意義（P>0.05）。結論 微通道經皮腎鏡治療嵌頓性輸尿管上段結石的臨床效果肯定，并有操作簡單、康復快等優勢，在結石取凈率方面也有優越性，值得借鑒。

[關鍵詞]結石取凈率;微通道經皮腎鏡;后腹腔鏡;嵌頓性輸尿管上段結石

[中圖分類號] R693.4? ? ? ? ? [文獻標識碼] A? ? ? ? ? [文章編號] 1674-4721（2019）6（a）-0086-03

[Abstract] Objective To investigate the clinical effect of microchannel percutaneous nephroscopy and retroperitoneal laparoscopy in the treatment of incarcerated upper ureteral calculi. Methods A total of 80 cases of incarcerated upper ureteral calculi admitted to our hospital from January 2017 to March 2018 were selected as research objects. The patients were divided into two groups， with 40 cases in each group. The control group was treated by retroperitoneal laparoscopic lithotomy， and the study group was treated by microchannel percutaneous nephroscopy. Operative time， intraoperative bleeding， stone removal rate， length of hospital stay， visual analogue score （VAS） for postoperative pain and complications were compared between the two groups. Results The operation time and hospitalization time of patients in the study group were shorter than those in the control group， and the VAS score of 24 h after surgery was lower than that in the control group， the differences were statistically significant （P<0.05）， while there was no significant difference in intraoperative blood loss between the two groups （P>0.05）. The stone removal rate in the study group （100.00%） was higher than that in the control group （90.00%）， and the difference was statistically significant （P<0.05）. The total incidence of complications in the study group （5.00%） was compared with that in the control group （7.50%）， and the difference was not statistically significant （P>0.05）. Conclusion Microchannel percutaneous nephrolithotomy for the treatment of incarcerated upper ureteral calculi has definite clinical effect， and has the advantages of simple operation， quick recovery and so on. It also has advantages in stone removal rate and is worth learning.

[Key words] Stone clearance rate; Microchannel percutaneous nephroscopy; Retroperitoneal laparoscopy; Incarcerated upper ureteral calculi