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目的比较后腹腔镜下输尿管切开取石(RLTP)术与微创经皮肾碎石术(miniPCNL)治疗输尿管上段结石的临床效果。方法分析45例输尿管上段结石治疗的临床资料,其中25例采用minPCNL术,20例行RLTP术,比较两种方法的手术时间、术中失血量、结石清除率、引流管放置时间和住院天数等的差别。结果miniPCNL组均获成功,RLTP组有2例因结石处输尿管粘连严重中转开放,1例因结石移位而只放置双J管。手术时间miniPCNL组小于RLTP组(P<0.01);术中失血量miniPC-NL组大于RLTP组(P<0.01);术后住院天数、引流管放置时间、结石清除率无明显差别(P>0.05)。结论后腹腔镜与微创经皮肾碎石术均具有微创、出血少、恢复快而又安全有效的特点,在处理输尿管上段结石时微创经皮肾碎石术可同时处理肾脏结石具有一定的优势,但应根据患者的不同情况采取合适的方法。
Objective To compare the clinical effects of laparoscopic ureteralotomy (RLTP) and minimally invasive percutaneous nephrolithotomy (miniPCNL) in the treatment of upper ureteral calculi. Methods The clinical data of 45 patients with upper ureteral calculi were analyzed. Among them, minPCNL was used in 25 cases and RLTP was performed in 20 cases. The operation time, intraoperative blood loss, stone clearance rate, drainage tube placement time and days of hospitalization were compared The difference. Results All the patients in miniPCNL group were successful. Two patients in RLTP group had severe ureterocele adhesion and metastasis, and only one double J tube was placed in one patient because of stone metastasis. The miniPC-NL group was larger than the RLTP group (P <0.01), the length of postoperative hospital stay, drainage tube placement time and stone clearance rate were not significantly different (P> 0.05) ). Conclusions Retroperitoneal laparoscopy and minimally invasive percutaneous nephrolithotomy have the characteristics of minimally invasive, less bleeding, quick and safe recovery. In minimally invasive percutaneous nephrolithotomy, the minimally invasive percutaneous nephrolithotomy can treat renal stones with Certain advantages, but should be based on the patient’s situation to take the appropriate method.