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目的探讨基层医院采用腹腔镜治疗输尿管上段结石的临床效果。方法选取我院收治的440例输尿管上段结石患者,将患者根据治疗方法分为体外冲击波碎石组(ESWL组,92例)、传统开放性输尿管切开取石组(UL组,92例)、微创经皮肾镜取石术组(MPCNL组,136例)及后腹腔镜下输尿管上段切开取石术组(RLU组,120例)。比较4组患者手术时间、术中出血量、一次治疗成功率及住院时间。结果治疗后MPCNL组、RLU组与UL组一次性治疗成功率均明显高于ESWL组,差异均有统计学意义(均P<0.05);ESWL组术中出血量明显少于其他3组,差异有统计学意义(P<0.05);而在手术时间、住院时间方面,RLU组明显短于其他3组,差异均有统计学意义(均P<0.05)。结论 RLU操作简单,安全性高,创伤小,恢复快,尤其对输尿管嵌顿性结石治疗效果最佳,可取代其他治疗方法。
Objective To investigate the clinical effect of laparoscopic primary ureteral calculi in primary hospitals. Methods A total of 440 patients with upper ureteral stones admitted to our hospital were enrolled and divided into ESWL group (n = 92), traditional open ureteral calculi group (n = 92) Percutaneous nephrolithotomy (MPCNL group, 136 cases) and retroperitoneal laparoscopic ureterolithotomy (RLU group, 120 cases). The operation time, intraoperative blood loss, primary treatment success rate and hospital stay were compared between the 4 groups. Results The success rates of one-time treatment in MPCNL group, RLU group and UL group were significantly higher than those in ESWL group after treatment (all P <0.05). The bleeding volume in ESWL group was significantly less than the other three groups (P <0.05). However, in the operation time and hospital stay, the RLU group was significantly shorter than the other three groups (all P <0.05). Conclusion RLU is simple, safe, less traumatic and faster to recover, especially for ureteral incarcerated stones, which can replace other treatment methods.