摘要
目的探讨后腹腔镜输尿管切开取石术治疗上段输尿管结石的安全性和有效性。方法连续收集2005年10月至2010年3月在景德镇市第一人民医院行手术治疗的上段输尿管结石患者81例,按随机数字表法将入组患者分为腹腔镜组(行后腹腔镜输尿管切开取石术,40例)和开放组(行开放输尿管切开取石术,41例)。观察并记录手术时间、术中出血量、术后肠功能恢复时间、术后下床活动时间、术后抗生素使用时间、拔除引流管时间、拔除导尿管时间、术后住院时间、止痛药使用情况、术后并发症情况、手术费用及住院总费用,并于出院后密切随访,了解患者结石复发及输尿管狭窄情况。结果腹腔镜组手术时间、术中出血量、术后肠功能恢复时间、术后下床活动时间、术后抗生素使用时间、术后住院时间、止痛药服用例数及并发症发生率方面均显著优于开腹组(均P<0.05);然而,其住院治疗总费用却明显高于开腹组(P<0.05)。两组患者在引流管和导尿管拔除时间上的差异无统计学意义(均P>0.05)。两组患者经3～55个月的随访,无一例出现结石复发及输尿管狭窄。结论后腹腔镜输尿管切开取石术安全、有效,具有创伤小、疼痛轻、恢复快等优点,具有一定的临床推广价值。
Objective To evaluate the safety and efficacy of retroperitoneal laparoscopic ureterolithotomy for the treatment of upper ureteral calculi.Methods A total of 81 patients with upper ureteral calculi recruited in our hospital from October 2005 to March 2010 were randomly divided into laparoscopy group（retroperitoneal laparoscopic ureterolithotomy） and control group（open ureterolithotomy）.The perioperative parameters were recorded and compared in the two groups.Results The time of operation,bowel function recovery ambulant time,antibiotics usage,hospital stay in laparoscopy group were significantly shorter than those in control group（all P0.05）.The laparoscopy group had less blood loss,fewer analgesic use,lower complication rate and higher total hospitalization expenses than those in control group（P0.05）.The time of drainage tube and urinary catheter extraction had no significant difference between two groups（P0.05）.During 3-55 months follow-up,no ureteral stricture occured.Conclusions Retroperitoneal laparoscopic ureterolithotomy is a safe and effective approach for upper ureteral calculi with minor damage,less pain and rapid recovery,and has certain popularized value.
出处
《中华腔镜泌尿外科杂志（电子版）》
2010年第4期14-16,共3页
Chinese Journal of Endourology(Electronic Edition)
关键词
输尿管结石
切开取石术
腹腔镜
Ureteral calculus Ureterolithotomy Laparoscopic
