输尿管软镜与微创经皮肾镜治疗输尿管上段结石的对比

王威

[摘要] 目的 探討输尿管软镜与微创经皮肾镜治疗输尿管上段结石的疗效差异。方法 方便收集2015年4月—2017年9月该院输尿管上段结石的96例患者，随机分为研究组（接受输尿管软镜治疗）和对照组（接受微创经皮肾镜治疗）。分析对比两组手术相关指标；两组术后镇痛剂使用率、结石残留率；两组术后并发症发生率。结果 研究组和对照组手术相关指标手术时间、术中出血量、住院天数分别为（69.63±12.87）min、5.37±5.82）mL、（5.32±2.87）d、（78.25±10.23）min、（9.41±2.58）mL、（7.36±1.25）d，差异有统计学意义（t=7.15、5.88、6.37，P<0.05）；研究组和对照组术后镇痛剂使用率、结石残留率分别为（4%、6%）、（24%、22%），差异有统计学意义（χ2=8.52、6.34，P<0.05）；研究组和对照组术后并发症发生率分别为2%、4%，比较差异有统计学意义（χ2=5.37，P<0.05）。结论 该文认为与微创经皮肾镜相比，输尿管软镜治疗输尿管上段结石手术损伤小，术后患者恢复快，结石残留率低。

[关键词] 微创经皮肾镜；输尿管软镜；输尿管；结石

[中图分类号] R5 [文献标识码] A [文章编号] 1674-0742（2018）05（a）-0035-03

Comparison of Flexible Ureteroscopic Lithotripsy and Minimally Invasive Percutaneous Nephrolithotomy in Treatment of Upper Ureteral Calculi

WANG Wei

Shandong Coal Linyi Hot Spring Sanatorium， Linyi， Shandong Province， 276032 China

[Abstract] Objective To study the difference in the curative effect of flexible ureteroscopic lithotripsy and minimally invasive percutaneous nephrolithotomy in treatment of upper ureteral calculi. Methods 96 cases of patients with upper ureteral calculi admitted and treated in our hospital from April 2015 to September 2017 were convenient selected and randomly divided into two groups， the research group and the control group were respectively treated with flexible ureteroscopic lithotripsy and minimally invasive percutaneous nephrolithotomy， and the antalgic usage rate， stone residual rate， and incidence rate of complications after surgery were analyzed and compared. Results The operation time， intraoperative bleeding amount and length of stay in the research group and in the control group were respectively （69.63±12.87）min， （5.37±5.82）mL，（5.32±2.87）d，（78.25±10.23）min，（9.41±2.58）mL，（7.36±1.25）d， and the difference was statistically significant（t=7.15， 5.88， 6.37， P<0.05）， and the indicators in the research group and in the control group was respectively （4%， 6%），（24%， 22%）， and the differences were statistically significant（χ2=8.52， 6.34， P<0.05）， and the incidence rate of complications after surgery in the research group and in the control group was respectively 2%， 4%， and the difference was obvious， with statistical significance（χ2=5.37， P<0.05） . Conclusion The injury of flexible ureteroscopic lithotripsy in treatment of upper ureteral calculi is smaller than that of minimally invasive percutaneous nephrolithotomy with rapid recovery and low stone residual rate.

[Key words] Minimally invasive percutaneous nephrolithotomy； Flexible ureteroscopic lithotripsy； Ureter； Stone

泌尿系统结石是一种常见的多发病，最早在3000年前，人类已经有关泌尿系结石的记载。泌尿系统结石中输尿管结石占33%～54%，而输尿管上段结石是临床常见的嵌顿部位，临床症状表现为肾绞痛、肾积水、血尿等。大部分较小的结石可以通过药物排石治疗自行排出，但是对于直径大于8 mm者采取手术治疗效果更好[1]。考虑到开放性手术创伤大，目前泌尿外科已经向微创手术治疗的方向发展，通过微创手可以极大程度的避免术后患者出现输尿管狭窄并发症的发生。目前治疗输尿管上段结石的微创手术方法多样：如输尿管镜钬激光碎石术、后腹腔镜输尿管切开取石术、微创经皮肾镜与输尿管软镜等。该研究方便收集2015年4月—2017年9月该院输尿管上段结石的96例患者，分析输尿管软镜与微创经皮肾镜的治疗差异，现报道如下。

1 资料与方法

1.1 一般资料

方便收集该院输尿管上段结石的96例患者，患者入院时已通过B超、CT确诊为输尿管上段结石。……