微创经皮肾镜取石术治疗输尿管上段嵌顿性结石的临床观察

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1、微创经皮肾镜取石术治疗输尿管上段嵌顿性结石的临床观察［摘耍］冃的观察微创经皮肾镜取石术(MPCNL)治疗嵌顿性输尿管上段结石的疗效。方法冋顾性分析单侧输尿管上段结石伴嵌顿患者115例，根据患者的选择分别采用MPCNL(65例)和经尿道输冰管镜取石术(URL)(50例)治疗，分别对其结石清除率、手术时间、住院时间、术中并发症发生率、术后辅助治疗、术后并发症等数据进行对比分析。结果MPC7L组的术后3d结石清除率为100.00%,而URL组的术后3d结石清除率为62.00%,两组比较差异有统计学意义(P=0)o随访术后1个月的结石清除率，MPCM组为100

2、.00%,较URL组的84.00%明显提高(P=0.001)。MPCNL组的手术时间(t=5.753,P=0)和住院时间(t=8.635,P=0)较URL组的明显缩短。两组术中并发症、术后感染和血红蛋白下降发生率比较,差异无统计学意义(P>0.05)。而MPCNL组术后辅助体外冲击波碎石术(ESWL)治疗率为1.54%,明显低于URL组的18.00%,差异有统计学意义(P=0.002)。结论MPCNL治疗嵌顿性输床管上段结石结石清除率高、并发症少、安全有效，可作为嵌顿性输尿管上段结石的首选治疗方法。［关键词］微创经皮肾镜取石术；输尿管镜；输尿管结石［中

3、图分类号］R693+.4［文献标识码］A［文章编号］1673-7210(2012)01(c)-0065-03ClinicalobservationofminimallyinvasivepercutaneousnephrolithotomyinthetreatmcntofimpactedupperureteralstonesZHANGJiongLANGGenqiangZHANGYifengCHUJianZHUANGJianqiuCAOJianweiDepartmentofUrinarySurgery,the411thHospitalofPLA,Shang

4、hai200081,China［Abstract］ObjectiveToexploretheeffectoftheminimallyinvasivepercutaneousnephrolithotomy(MPCNL)inthetreatmentofimpactedupperureteralstones.Methods115casesofofimpactedupperureteralstoneswerestudiedretrospectively.Accordingtotheselectionofoperation,65caseswereunderwen

5、tminimallyinvasivepercutaneousnephrolithotomy1ithotomy(MPCNLgroup)and50caseswereunderwentureteroscopiclithotripsy(URLgroup)•Thestone-freerate,operativetime,hospitalstay,incidenceofintraoperativecomplications,postoperativeadjuvanttherapy,postoperativecomplicationsandotherdatawere

6、analyzed・ResultsThestone-frccrateat3daysfollow-upwas100.00%inMPCNLgroup,62.00%inURLgroup,thedifferencewasstatisticallysignificant(P=0).Thestone-freerateatonemonthfollow-upwas100.00%inMPCNLgroupand84.00%inURLgroup(P=0.001).InMPCNLgrouptheoperativetime(t=5・753,P=0)andhospitalstay(

7、t=8.635,P=0)weresignificantlyshorterthanthoseinURLgroup・Therewerenosignifiesntdifferenccsintheratesofintraoperativecomplications,postoperativeinfectionandhemoglobindeclinebetweenthetwogroups(P>0.05).TnMPCNLgroup,theratesofadjuvantESWLwas1.54%,significantlylowerthan18.00%inURLgro

8、up(P=0.002).ConclusionMPCNLforimpactedupperuret