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URSL、FURS和MPCNL治疗输尿管上段嵌顿性结石的疗效和安全性的比较 被引量:30

Comparison of the efficacy and safety of URSL, FURS and MPCNL for treatment of large upper impacted ureteral stones
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摘要 目的比较微创经尿道输尿管镜联合钬激光碎石取石术(URSL)、输尿管软镜联合钬激光碎石取石术(FURS)和经皮肾镜碎石取石术(MPCNL)3种术式的优缺点,探讨治疗上段输尿管嵌顿性结石的术式选取。方法选取2015年1月-2017年12月广州医科大学附属第五医院上段输尿管结石(>15 mm)患者150例。将患者按1∶1∶1的比例随机分为URSL组、FURS组及MPCNL组。主要分析指标为治疗成功率、术后1个月的结石清除率,次要分析指标为术中、术后的相关参数,以及与手术相关并发症的发生情况。结果URSL组的治疗成功率和结石清除率为62.0%和72.0%;FURS组为82.0%和91.1%;MPCNL组为94.0%和96.0%。3组治疗成功率、平均手术时间、术后住院时间比较,差异有统计学意义(P<0.05);3组需辅助体外冲击波碎石术(ESWL)辅助率与术后1个月结石消除率比较,差异无统计学意义(P>0.05)。URSL组的治疗成功率低于FURS组和MPCNL组。MPCNL组治疗成功率优于FURS组。URSL组平均手术时间、术后住院时间优于另外两组。结论MPCNL和FURS具有大致相同的结石清除率,均优于URSL,可能更适用于上段输尿管嵌顿性结石的治疗。与MPCNL比较,FURS治疗失败及术后感染风险均较高。此外,如果患者不适合行全身麻醉或手术耐受力差,可考虑行URSL。 Objective To compare mini-percutaneous nephrolithotomy(MPCNL),transurethral ureteroscope lithotripsy(URSL)and flexible ureteroscopy with holmium laser(FURS),and to evaluate which one is the best choice for large upper impacted ureteral stones.Methods Totally 150 consecutively enrolled patients with a large upper impacted ureteral stone(>15 mm)were included.The patients were randomly divided(1:1:1)into the MPCNL,URSL,and FURS group.The main outcome measures were the success rate of treatment,the stone clearance rate 1 month after operation;the secondary outcome measures were the relevant parameters during and after operation,and the occurrence of complications related to operation.Results The success rate of treatment and stone clearance rate were 94.0%and 96.0%in the MPCNL group,82.0%and 91.1%in the FURS group,and 62.0%and 72.0%in the URSL group.There were statistically significant differences in the success rate of treatment,average operation time and postoperative hospital stay among the three groups(P<0.05);the three groups needed to be assisted with ESWL.ESWL assisted rate compared with stone elimination rate one month after operation,and the difference was not statistically significant(P>0.05).The success rate of URSL group was lower than that of FURS group and MPCNL group.The success rate of MPCNL group was better than that of FURS group.The average operation time and postoperative hospitalization time of URSL group were better than those of the other two groups.Conclusions MPCNL and FURS have the same stone clearance rate,which are better than URSL,and may be more suitable for the treatment of upper ureteral impacted stones.Compared with MPCNL,failure of FURS treatment and postoperative infection risk were higher.In addition,if the patient is not suitable for general anesthesia or poor surgical tolerance,URSL can be considered.
作者 李天 江先汉 谢清灵 黄亦桥 刘一帆 殷羽天 Tian Li;Xian-han Jiang;Qing-ling Xie;Yi-qiao Huang;Yi-fan Liu;Yu-tian Yin(Department of Urology Surgery,The Fifth Affiliated Hospital of Guangzhou Medical University,Guangzhou,Guangdong 510700,China)
出处 《中国现代医学杂志》 CAS 2020年第3期74-80,共7页 China Journal of Modern Medicine
关键词 输尿管结石 经皮肾镜碎石取石术 经尿道输尿管镜联合钬激光碎石取石术 输尿管软镜联合钬激光碎石取石术 结石清除率 ureteral calculi nephrolithotomy percutaneous transurethral ureteroscopy combined with holmium laser lithotripsy ureteroscopy combined with holmium laser lithotripsy stone clearance rate
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  • 1刘星明,任胜强,邬旭明,袁鹤胜,蔡雅富,桑乾宏,方建军,梁宇,王强辉.微创经皮肾镜取石术治疗复杂性输尿管上段结石[J].临床泌尿外科杂志,2006,21(2):88-89. 被引量:28
  • 2李信众,梁建波,刘刚,蓝志相,韦华玉.B超引导多通道微创经皮输尿管镜治疗复杂性肾结石[J].微创医学,2007,2(6):592-593. 被引量:8
  • 3You JH, Kim YG, Kim MK. Flexible ureteroscopic renal stone extrac- tion during laparoscopic ureterolithotomy in patients with large upper ureteral stone and small renal stones [ J ]. Can Urol Assoc J,2014,8 (9- 10) :591-594.
  • 4Kanno T, Kubota M, Sakamoto H, et al. Determining the efficacy of ul- trasonography for the detection of ureteral stone [ J ]. Urology, 2014,84 (3) :533-537.
  • 5Lee SW, Woo SH, Yoo DS, et al. Effect of tamsulosin on stone expul- sion in proximal ureteral calculi:an open-label randomized controlled trial[ J ]. Int J Clin Praet,2014,68 (2) :216-221.
  • 6Park YH, Lee HE, Park JY, et al. A prospective randomized controlled trial of the efficacy of tamsulosin after extracorporeal shock wave litho- tfipsy for a single proximal ureteral stone[ J]. Korean J Urol,2013,54 (8) :527-530.
  • 7He Y, Li NN, Chen Z, et al. Retroperitoneal laparoendoscopic single- site ureterolithotomy for upper ureteral stone disease [ J ]. Scand J Urol,2013,47 (6) :515-520.
  • 8Khalil M. Management of impacted proximal ureteral stone: Extracor- poreal shock wave lithotripsy versus ureteroscopy with holmium : YAG laser lithotripsy [ J ]. Urol Ann,2013,5 ( 2 ) : 88 -92.
  • 9Hemal AK,Goel A,Goel R.Minimally invasive retroperitoneoscopi c ureterolithotomy[J].J Urol,2003,169(2):480-482.
  • 10Degirmenci T, Gunlusoy B, Kozacioglu Z, et al. Outcomes of Ureteroscopy for the Management of Impacted Ureteral Calculi With Different Localizations [ J ].Urology, 2012,80 (4) :811-815.

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