摘要
目的比较后腹腔镜输尿管切开取石术与输尿管镜钬激光碎石术(URSL)治疗输尿管结石并肾积脓的疗效和安全性。方法选取2016年1月至2018年1月期间在本院治疗的输尿管结石并肾积脓患者96例,根据手术方式不同分为观察组和对照组。观察组患者采用后腹腔镜输尿管切开取石术治疗,对照组患者采用URSL治疗,比较两组患者手术时间、结石清除率、术后感染等并发症的发生率,分析两种治疗方式的临床疗效。结果对照组手术时间(41.26±11.33)min,显著低于观察组(75.55±15.50)min,但观察组结石清除率(100%)显著高于对照组(68.8%),观察组未发生全身炎症反应综合征(SIRS)和感染性休克,而对照组(SIRS)发生率高达54.2%,感染性休克发生率达到10%,两组比较差异均有统计学意义(P<0.05);观察组住院时间(8.56±1.08)d,对照组住院时间(8.39±0.96)d,两组患者住院时间比较差异无统计学意义(P>0.05)。结论后腹腔镜输尿管切开取石治疗输尿管结石并肾积脓具有较好的临床疗效,且结石清除率高、术后SIRS及其他并发症发生率低,是治疗输尿管结石并肾积脓的一种安全有效方法。
Objective To compare efficacy and safety of laparoscopic ureterolithotomy and ureteroscopic holmium laser lithotripsy for ureteral calculi and renal empyema.Methods During January 2016 to January 2018,96 patients with ureteral calculi and pyonephrosis who were treated in our hospital were selected and divided into retroperitoneal laparoscopy group and ureteroscopic group according to different surgical operation methods.The operation time,stone free rate,postoperative infection and other complications were compared between the two groups,and the clinical efficacy of the two treatment methods was analyzed.Results The operation time of the ureteroscopy group(41.26±11.33)min was significantly lower than that of the retroperitoneal laparoscopic group(75.55±15.50)min.The stone free rate of laparoscopic group(100%)was significantly higher than that of ureteroscopic group(68.8%).There was no systemic inflammatory response syndrome(SIRS)and septic shock in the retroperitoneal laparoscopic group,and the incidence of ureteroscopy(SIRS)was as high as 54.2%,and the incidence of septic shock was 10%.The results were statistically significant(P<0.05).The average length of hospital stay in the laparoscopic group(8.56±1.08)d and the average hospital stay in the ureteroscopy group(8.39±0.96)d.There was no statistically significant difference in the average length of hospital stay between the two groups(P>0.05).Conclusions Retroperitoneal laparoscopic ureterolithotomy for ureteral calculi complicated with pyonephrosis is a safe and effective method,which performs a good clinical efficacy,with high stone free rate,low incidence of postoperative SIRS,can significantly reduce the occurrence of surgical complications in patients with ureteral calculi and pyonephrosis.
作者
招云亮
高媛
王跃强
张贵福
田雨
黄曦
Zhao Yunliang;Gao Yuan;Wang Yueqiang;Zhang Guifu;Tian Yu;Huang Xi(Department of Urology,the First People's Hospital of Honghe,Mengzi 661199,China;Department of Precision Medical Diagnostic Center,the First People's Hospital of Honghe,Mengzi 661199,China)
出处
《国际泌尿系统杂志》
2020年第4期642-645,共4页
International Journal of Urology and Nephrology
