微创经皮肾镜治疗输尿管上段结石效果观察(1)
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[摘要] 目的 观察分析微创经皮肾镜治疗输尿管上段结石的方法及临床效果。 方法 选取49例输尿管上段结石患者为研究对象，随机分为两组，对照组给予输尿管镜取石术治疗，观察组给予微创经皮肾镜治疗，分析其一般资料、手术方法，观察手术时间、手术成功率及结石清除率。 结果 观察组手术时间明显短于对照组，手术Ⅰ期成功率及结石清除率差异有统计学意义(P<0.05)。 结论 微创经皮肾镜治疗输尿管上段结石手术方法简单有效，结石清除率较高，对于肾积水及位置较高、距肾盂较近的结石清除效果较好，值得临床推广应用。
[关键词] 经皮肾镜；微创；泌尿外科；输尿管上段结石
[中图分类号] R699 [文献标识码] B [文章编号] 1673-9701(2012)02-0137-02
Effect observation of minimally invasive percutaneous nephrolithotomy for the treatment of upper ureteral calculi
FENG Haihang HUANG Xiaojia XU Xiang
Department of Urology, Baoan District People's Hospital, Shenzhen 518101, China
[Abstract] Objective To observe and analyze the method and clinical effect of minimally invasive percutaneous nephrolithotomy in the treatment of upper ureteral calculi. Methods Fourty-nine cases of upper ureteral calculi patients in this study were randomly divided into two groups, the control group received ureteroscopic lithotripsy, and the observation group received minimally invasive percutaneous nephrolithotomy; The general information, surgical methods, operative time, operative success rate and stone clearance rate of two groups were observed and analyzed. Results The operative time of the observation group was significantly shorter than that of the control group, and the surgical success rate of stage Ⅰ and stone clearance rate were significantly different (P<0.05). Conclusion Minimally invasive percutaneous nephrolithotomy in the treatment of upper ureteral calculi is simple and effective, and has higher stone clearance rate and better efficacy for hydronephrosis or calculi with higher position nearing from the renal pelvis, and is worthy of clinical application.
[Key words] Percutaneous nephrolithotomy; Minimally invasive; Urology; Upper ureteral calculi
尿石症为泌尿外科常见病，患病率约为1%～5%，年新发病率为0.05%～0.30%[1]。输尿管上段结石的传统治疗方法为经皮肾镜取石，肾实质的穿刺孔大，并发症发生几率较高，同时由于肾镜直径过大，难以通过狭小肾盏的颈部，所以结石清除率不高。近些年腔内泌尿外科学发展迅速，微创经皮肾输尿管镜取石术(minimally invasive percutaneous nephrolithotomy，MPCNL)已逐渐应用于临床治疗泌尿系统结石，绝大部分的输尿管上段结石已无需开放式手术治疗[2]。本文总结分析我院近年来采用微创经皮肾镜治疗输尿管上段结石的方法及临床效果，现报道如下。
1 资料与方法
1.1 一般资料
选取我院泌尿外科2007年1月～2010年1月收治的49例输尿管上段结石患者为研究对象，其中男33例，女16例，年龄22～71岁，平均45.3岁。左侧输尿管结石30例，右侧输尿管结石19例，结石大小7mm × 5mm～26mm × 15mm ......
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