微创经皮肾镜取石术和经输尿管镜气压弹道碎石取石术治疗输尿管上段结石合并肾积水的优劣差异(1)
【摘要】 目的：分析探讨微创经皮肾镜取石术(MPCNL)和经输尿管镜气压弹道碎石取石术(URL)治疗输尿管上段结石合并肾积水的优劣差异。方法：选取2016年1月-2018年12在笔者所在科室接受治疗的输尿管上段结石合并肾积水的患者60例，依照随机数字表法随机分为试验组(MPCNL)和对照组(URL)，每组30例。从结石清除情况、入院治疗情况、并发症发生情况三方面对两种治疗方法的优劣进行分析比较。结果：试验组术后3 d、1个月结石清除率均优于对照组，差异均有统计学意义(P<0.05);试验组住院时间、手术时间均长于对照组，手术出血量高于对照组，差异均有统计学意义(P<0.05);试验组术后并发症发生率为23.33%，对照组为10.00%，组间比较差异无统计学意义(P>0.05)。结论：微创经皮肾镜取石术和经输尿管结石取石术在治疗输尿管上段结石合并腎积水中各有优劣，MPCNL具有结石清除率高的优势，但手术创伤大，用时久，治疗时间相对较长;URL则创伤小，用时短，康复快，但结石清除率相对不高。
【关键词】 输尿管上段结石 肾积水 经皮肾镜 经输尿管镜
doi：10.14033/j.cnki.cfmr.2020.24.061 文献标识码 B 文章编号 1674-6805(2020)24-0-03
[Abstract] Objective： To evaluate the advantages and disadvantages of minimally invasive percutaneous nephrolithotomy (MPCNL) and ureteroscopic pneumatic lithotripsy (URL) in treatment of upper ureteral combined with hydronephrosis. Method： A total of 60 patients with upper ureteral calculi combined with hydronephrosis who received treatment in the author’s department from January 2016 to December 2018 were selected. According to the random number table method， the patients were randomly divided into the experimental group (MPCNL) and the control group (URL)， with 30 patients in each group. The advantages and disadvantages of the two treatment methods were analyzed and compared from the perspectives of stone clearance， hospital treatment and complications. Result： The calculi clearance rates at 3 d and 1 month after operation in the experimental group were better than those in the control group， the differences were statistically significant (P<0.05). The length of hospital stay and operation time in the experimental group were longer than those in the control group， and the amount of operative blood loss was higher than that in the control group， the differences were statistically significant (P<0.05). The incidence of postoperative complications was 23.33% in the experimental group and 10.00% in the control group， with no statistically significant difference (P>0.05). Conclusion： Both minimally invasive percutaneous nephrolithotomy and transureteral lithotomy have advantages and disadvantages in the treatment of upper ureteral calculi combined with hydronephrosis. MPCNL has the advantage of high stone clearance rate， but the surgical trauma is large， the time is long and the treatment time is relatively long. URL is less traumatic， short time， quick recovery， but the stone clearance rate is relatively low.
[Key words] Upper ureteral calculi Hydronephrosis Percutaneous nephroscope Transureteroscope, 百拇医药(李国文 周灿轩 李民 徐元茂 王晨庄 陈莉莉)
【关键词】 输尿管上段结石 肾积水 经皮肾镜 经输尿管镜
doi：10.14033/j.cnki.cfmr.2020.24.061 文献标识码 B 文章编号 1674-6805(2020)24-0-03
[Abstract] Objective： To evaluate the advantages and disadvantages of minimally invasive percutaneous nephrolithotomy (MPCNL) and ureteroscopic pneumatic lithotripsy (URL) in treatment of upper ureteral combined with hydronephrosis. Method： A total of 60 patients with upper ureteral calculi combined with hydronephrosis who received treatment in the author’s department from January 2016 to December 2018 were selected. According to the random number table method， the patients were randomly divided into the experimental group (MPCNL) and the control group (URL)， with 30 patients in each group. The advantages and disadvantages of the two treatment methods were analyzed and compared from the perspectives of stone clearance， hospital treatment and complications. Result： The calculi clearance rates at 3 d and 1 month after operation in the experimental group were better than those in the control group， the differences were statistically significant (P<0.05). The length of hospital stay and operation time in the experimental group were longer than those in the control group， and the amount of operative blood loss was higher than that in the control group， the differences were statistically significant (P<0.05). The incidence of postoperative complications was 23.33% in the experimental group and 10.00% in the control group， with no statistically significant difference (P>0.05). Conclusion： Both minimally invasive percutaneous nephrolithotomy and transureteral lithotomy have advantages and disadvantages in the treatment of upper ureteral calculi combined with hydronephrosis. MPCNL has the advantage of high stone clearance rate， but the surgical trauma is large， the time is long and the treatment time is relatively long. URL is less traumatic， short time， quick recovery， but the stone clearance rate is relatively low.
[Key words] Upper ureteral calculi Hydronephrosis Percutaneous nephroscope Transureteroscope, 百拇医药(李国文 周灿轩 李民 徐元茂 王晨庄 陈莉莉)