输尿管气压弹道碎石术和微创经皮肾镜碎石术治疗输尿管上段结石的疗效
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摘要
目的探究输尿管气压弹道碎石术与微创经皮肾镜碎石术治疗输尿管上段结石的临床疗效。方法随机选取本院2017年1月～2018年1月80例输尿管上段结石患者作为研究对象,采用随机法分为实验组与对照组,实验组42例采用微创经皮肾镜碎石术治疗,对照组采用输尿管气压弹道碎石术治疗,观察两组术中出血量、手术时间、住院时间及一次碎石成功率、并发症、复发率情况。结果微创经皮肾镜碎石术治疗的实验组,手术时间、及住院时间均短于对照组,术中出血量少于对照组,差异有统计学意义(P <0.05);实验组一次碎石成功率为95.2%,对照组为78.9%,差异有统计学意义(P <0.05);实验组并发症发生率为2.4%,对照组并发症发生率为10.5%,差异有统计学意义(P <0.05);经随访,实验疾病复发率为4.8%;对照组复发率为21.1%,实验组疾病复发率高于对照组,差异有统计学意义(P <0.05)。结论微创经皮肾镜碎石术治疗输尿管上段结石一次碎石成功率更高、出中出血量更少、手术时间与住院时间更短,且并发症少、术后复发率低,预后良好,值得采用。
Objective To explore the clinical curative effect of ureteral pneumatic lithotripsy and minimally invasive percutaneous nephrolithotomy in treatment of upper ureteric calculi. Methods 80 patients with upper ureteric calculi who were admitted to our hospital from January 2017 to January 2018 were randomly selected as research objects.They were randomly divided into the experimental group and the control group.42 patients in the experimental group were treated with minimally invasive percutaneous nephrolithotomy.Patients in the control group were treated with ureteral pneumatic lithotripsy.The intraoperative blood loss,operation time,hospital stay,the success rate of primary lithotripsy,complications and recurrence rate in two groups were observed. Results In the experimental group treated with minimally invasive percutaneous nephrolithotomy,the operation time and hospital stay were shorter than those of the control group and intraoperative blood loss was less than that of the control group.The comparison was statistically significant(P < 0.05).The success rate of primary lithotripsy in the experimental groupwas 40(95.2%),and that of the control group was 30(78.9%).The comparison was statistically significant(P< 0.05).The incidence of complications in the experimental group was 2.4%,and that of complications in the control group was 10.5%.The comparison was statistically significant(P < 0.05).By follow-up,the recurrence rate of the experimental disease was 4.8% and that of the control group was 21.1%.The recurrence rate of the experimental group was higher than that of the control group,and the comparison was statistically significant(P < 0.05). Conclusion Mminimally invasive percutaneous nephrolithotomy in treatment of upper ureteric calculi has a higher success rate of primary lithotripsy,less intraoperative blood loss,shorter operation time and hospital stay,fewer complications and lower recurrence rats.It has good prognosis,which is worthy of adoption.
Objective To explore the clinical curative effect of ureteral pneumatic lithotripsy and minimally invasive percutaneous nephrolithotomy in treatment of upper ureteric calculi. Methods 80 patients with upper ureteric calculi who were admitted to our hospital from January 2017 to January 2018 were randomly selected as research objects.They were randomly divided into the experimental group and the control group.42 patients in the experimental group were treated with minimally invasive percutaneous nephrolithotomy.Patients in the control group were treated with ureteral pneumatic lithotripsy.The intraoperative blood loss,operation time,hospital stay,the success rate of primary lithotripsy,complications and recurrence rate in two groups were observed. Results In the experimental group treated with minimally invasive percutaneous nephrolithotomy,the operation time and hospital stay were shorter than those of the control group and intraoperative blood loss was less than that of the control group.The comparison was statistically significant(P < 0.05).The success rate of primary lithotripsy in the experimental groupwas 40(95.2%),and that of the control group was 30(78.9%).The comparison was statistically significant(P< 0.05).The incidence of complications in the experimental group was 2.4%,and that of complications in the control group was 10.5%.The comparison was statistically significant(P < 0.05).By follow-up,the recurrence rate of the experimental disease was 4.8% and that of the control group was 21.1%.The recurrence rate of the experimental group was higher than that of the control group,and the comparison was statistically significant(P < 0.05). Conclusion Mminimally invasive percutaneous nephrolithotomy in treatment of upper ureteric calculi has a higher success rate of primary lithotripsy,less intraoperative blood loss,shorter operation time and hospital stay,fewer complications and lower recurrence rats.It has good prognosis,which is worthy of adoption.
引文
[1]赖建华.微创经皮肾镜碎石与输尿管镜碎石术治疗嵌顿性输尿管上段结石的效果对比[J].中外医学研究,2018,16(12):38-39.
[2]蔡蕾,许海波.微创经皮肾镜取石术与钬激光碎石术对输尿管上段结石的疗效[J].当代医学,2018,24(6):106-108.
[3]叶海燕,林慧中,姜荣.尿路结石采用肾镜下气压弹道碎石的临床效果研究[J].当代医学,2017,23(33):111-112.
[4]邱敏,宗亚楠,李焕荣,等.一期微创手术治疗肾肿物合并输尿管结石[J].中国微创外科杂志,2018,18(11):1027-1029.
[5]吴建惠,何屹,吴晓鸣,等.超声实时监测并调整治疗通道在体外冲击波碎石中的应用价值[J].临床泌尿外科杂志,2018,33(11):909-911.
[6]邹火生,黄裕清,余自强.经尿道输尿管镜碎石和微创经皮肾镜取石治疗输尿管上段嵌顿性结石的疗效比较[J].海南医学,2016,27(17):2853-2854.
[7]林海利,郑周达,刘洪杰,等.输尿管软镜碎石术治疗孤立肾上尿路结石36例[J].中国微创外科杂志,2018,18(10):878-880.
[8]王国平,王建锋,沈利红,等.微创经皮肾镜取石术与钬激光碎石术治疗输尿管上段结石的临床疗效对比分析[J].中华全科医学,2015,13(11):1892-1894.
[9]王昌兵,顾恒,叶大文,等.微创经皮肾穿刺气压弹道碎石取石术治疗输尿管上段复杂结石36例[J].中国内镜杂志,2015,21(4):427-428.
[10]刘功海,吴世东.气压弹道碎石术与微创经皮肾镜碎石术治疗输尿管上段结石的疗效比较[J].医学综述,2012,18(3):461-463.
[11]何跃,奉友刚,何俊,等.经皮肾镜微通道气压弹道碎石和输尿管软镜钬激光碎石治疗输尿管上段嵌顿性结石的疗效比较[J].四川医学,2016,37(3):329-331.
[12]张凯.腰硬联合麻醉在输尿管镜钬激光碎石术中的应用及安全性分析[J].慢性病学杂志,2018,19(10):1391-1392.
[13]王耀锋,杨海棠.微创经皮肾镜钬激光联合气压弹道碎石术治疗肾、输尿管上段结石研究[J].当代临床医刊,2016,29(6):2702.
[14]李新元.输尿管气压弹道碎石术和微创经皮肾镜碎石术治疗输尿管上段结石的疗效观察[J].临床合理用药杂志,2013,6(21):122.
[15]程文兵.经皮肾镜与输尿管镜在治疗嵌顿性输尿管上段结石中的疗效比较[J].中国医药科学,2015,5(10):168-170.
[2]蔡蕾,许海波.微创经皮肾镜取石术与钬激光碎石术对输尿管上段结石的疗效[J].当代医学,2018,24(6):106-108.
[3]叶海燕,林慧中,姜荣.尿路结石采用肾镜下气压弹道碎石的临床效果研究[J].当代医学,2017,23(33):111-112.
[4]邱敏,宗亚楠,李焕荣,等.一期微创手术治疗肾肿物合并输尿管结石[J].中国微创外科杂志,2018,18(11):1027-1029.
[5]吴建惠,何屹,吴晓鸣,等.超声实时监测并调整治疗通道在体外冲击波碎石中的应用价值[J].临床泌尿外科杂志,2018,33(11):909-911.
[6]邹火生,黄裕清,余自强.经尿道输尿管镜碎石和微创经皮肾镜取石治疗输尿管上段嵌顿性结石的疗效比较[J].海南医学,2016,27(17):2853-2854.
[7]林海利,郑周达,刘洪杰,等.输尿管软镜碎石术治疗孤立肾上尿路结石36例[J].中国微创外科杂志,2018,18(10):878-880.
[8]王国平,王建锋,沈利红,等.微创经皮肾镜取石术与钬激光碎石术治疗输尿管上段结石的临床疗效对比分析[J].中华全科医学,2015,13(11):1892-1894.
[9]王昌兵,顾恒,叶大文,等.微创经皮肾穿刺气压弹道碎石取石术治疗输尿管上段复杂结石36例[J].中国内镜杂志,2015,21(4):427-428.
[10]刘功海,吴世东.气压弹道碎石术与微创经皮肾镜碎石术治疗输尿管上段结石的疗效比较[J].医学综述,2012,18(3):461-463.
[11]何跃,奉友刚,何俊,等.经皮肾镜微通道气压弹道碎石和输尿管软镜钬激光碎石治疗输尿管上段嵌顿性结石的疗效比较[J].四川医学,2016,37(3):329-331.
[12]张凯.腰硬联合麻醉在输尿管镜钬激光碎石术中的应用及安全性分析[J].慢性病学杂志,2018,19(10):1391-1392.
[13]王耀锋,杨海棠.微创经皮肾镜钬激光联合气压弹道碎石术治疗肾、输尿管上段结石研究[J].当代临床医刊,2016,29(6):2702.
[14]李新元.输尿管气压弹道碎石术和微创经皮肾镜碎石术治疗输尿管上段结石的疗效观察[J].临床合理用药杂志,2013,6(21):122.
[15]程文兵.经皮肾镜与输尿管镜在治疗嵌顿性输尿管上段结石中的疗效比较[J].中国医药科学,2015,5(10):168-170.