摘要
目的:探讨复杂性输尿管上段结石的有效治疗方法。方法:回顾性分析逆行输尿管镜(URL)、微创经皮肾镜碎石术(MPCNL)以及后腹腔镜输尿管切开取石术(RLU)治疗复杂性输尿管上段结石患者的临床效果,比较3种治疗方法的成功率、碎石清除率及并发症。结果:210例患者中,URL治疗103例,1次手术成功率88.5%(91/103),11例输尿管输尿管镜无法到达结石部位,1例输尿管穿孔损伤改开放手术,术后1月结石清除率为85.0%。MPCNL治疗92例,1次手术成功率为92.4%(85/92),5例肾穿刺失败改开放手术,2例术中出血较多改2期手术,结石清除率为98.0%,并发症发生率为4.0%。RLU治疗15例,1次手术成功率为100%,结石1次取尽,无并发症。结论:3种微创手术方式皆有较好的疗效,各有优缺点,应根据患者临床需求及医院实际情况选择治疗方案。
Objective：To explore the treatment for complicated upper ureteric calculi. Methods： Retrospectively analyzed clinic effect of retrograde ureteroscope （URL）,mini-invasive percutaneous nephrolithotomy （MPCNL） and laparoscopic ureterolithotomy （RLU） on complicated upper ureteric calculi,compared the success rate,clearance and complication occurrence in patients with different treatment. Results： Out of 210 patients, 103 were treated by URL, in which 11 cases had ureteroscope failed in arriving ureteric calculi and 1 case had opening surgery due to ureteral perforation, with success rate for once surgery as 88.5% （91/103） and clearance after 1 month as 85.0%. 92 were treated by MPCNL, in which 2 cases had the second surgery due to over bleeding during operation and 5 cases had opening surgery due to renal biopsy failure, with success rate for once surgery as 98.0% （85/92）, clearance as 98.0% and complication occurrence as 7.0%. 15 were treated by RLU, with ureteric calculi cleared for once and success rate for once surgery as 100.0%, and without complication. Conclusion： With their own characters, three miniinvisive surgery methods are all effective. It is valuable to select therapy based on patients＇need and situation of hospital.
出处
《海南医学院学报》
CAS
2009年第12期1606-1607,1609,共3页
Journal of Hainan Medical University
基金
海南医学院科研基金资助学报项目(0020090288)~~
