经腹腹腔镜与微通道经皮肾镜治疗输尿管上段结石比较性研究

doi:10.19558/j.cnki.10-1020/r.2019.03.005

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摘要目的比较经腹腹腔镜取石术与微通道经皮肾镜碎石术治疗输尿管上段结石的临床疗效。方法回顾性分析2016年3月–2018年1月诊治的84例输尿管上段结石患者资料,其中41例患者行经腹腹腔镜输尿管切开取石术,43例患者行微通道经皮肾镜钬激光碎石术,比较两组患者手术时间、术中出血量、结石清除率、术后并发症、术后住院时间、术后肾积水恢复情况。结果平均手术时间腹腔镜组（50.3±11.1）min短于经皮肾镜组的（78.5±16.8）min;平均术中出血量腹腔镜组（15.5±2.7）mL少于经皮肾镜组（89.4±20.6）mL;两组患者结石清除率无差别;总并发症腹腔镜组为38例,经皮肾镜组为29例,行分级研究发现腹腔镜组疼痛发生率（92.7%）高于经皮肾镜组（25.4%）,术后感染、肾周血肿等并发症发生率经皮肾镜组（23.3%、18.6%）高于腹腔镜组,腹腔镜组无该类并发症的发生;术后住院时间腹腔镜组（8.1±0.7）d,与经皮肾镜组（6.8±2.3）d比较差异无统计学意义（P>0.05）;术后3个月复查肾积水恢复情况,两组患者均差异无统计学意义。结论与微通道经皮肾镜治疗输尿管上段结石相比,经腹腹腔镜组手术时间短、出血少、严重并发症少,但是术后切口疼痛明显。

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	冯瑞
	李中兴
	葛广成
	王星

关键词 ：腹腔镜, 经皮肾镜, 输尿管结石

Abstract：Objective: To compare the clinical efficacy of transabdominal laparoscopy and microchannel percutaneous nephroscopy in the treatment of upper ureteral calculi.Methods: From March 2016 to January 2018, 84 patients with upper ureteral calculi were retrospectively analyzed. Laparoscopic transabdominal ureterolithotomy was performed on 41 patients. Microchannel percutaneous nephrolithotomy with holmium laser lithotripsy was performed on 43 patients. The operation time, intraoperative blood loss, stone clearance rate, postoperative complications, hospitalization time and recovery of hydronephrosis were compared between the two groups. Results: The operation time in laparoscopic group was shorter than that in percutaneous nephroscopy group [(50.3±11.1) min vs. (78.5 +16.8) min]; the amount of intraoperative bleeding in laparoscopic group [(15.5±2.7) mL] was less than that in percutaneous nephroscopy group [(89.4±20.6) mL]; there was no significant difference in stone clearance rate between the two groups; complications occurred in 38 cases of laparoscopic group, and 29 cases in percutaneous nephroscopy group. The incidence of pain in laparoscopic group (92.7%) was higher than that in percutaneous nephroscopy group (25.4%). The incidence of postoperative infection and perirenal hematoma in percutaneous nephroscopy group was 23.3% and 18.6% respectively, which was higher than that in laparoscopic group. The postoperative hospital stay in laparoscopic group and percutaneous nephroscopy group was (8.1±0.7) days and (6.8±2.3) days, and there was no significant difference between the two groups (P>0.05). There was no significant difference in the recovery of hydronephrosis between the two groups at 3rd month after operation. Conclusion: As compared with the microchannel percutaneous nephrolithotomy in the treatment of upper ureteral calculi, the laparoscopic group had shorter operation time, less bleeding and fewer serious complications, but the incision pain was obvious after operation.

Key words： laparoscopy percutaneous nephrolithotomy ureteral calculi

收稿日期: 2018-11-06

ZTFLH:

R693.4

基金资助:镇江市科技创新重点研发计划——社会发展(SH2017021)

通讯作者: 冯瑞,21641620@qq.com

引用本文:

冯瑞, 李中兴, 葛广成, 王星. 经腹腹腔镜与微通道经皮肾镜治疗输尿管上段结石比较性研究[J]. 微创泌尿外科杂志, 2019, 8(3): 163-167.
FENG Rui, LI Zhongxing, GE Guangcheng, WANG Xing. Comparative study of transabdominal laparoscopy and microchannel percutaneous nephrolithotomy in the treatment of upper ureteral calculi. JOURNAL OF MINIMALLY INVASIVE UROLOGY, 2019, 8(3): 163-167.

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http://journal20.magtechjournal.com/Jwk_zgmnwk/CN/abstract/abstract1503.shtml 或 http://journal20.magtechjournal.com/Jwk_zgmnwk/CN/Y2019/V8/I3/163

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