摘要
目的探讨经后腹腔镜下输尿管切开取石术(RLUL)与微创经皮肾镜取石术(MPCNL)在治疗输尿管上段结石中的疗效及安全性。方法回顾性分析琼海市人民医院泌尿外科2021年1月至2022年1月收治的84例输尿管上段结石患者的临床资料,根据所采用的手术方法将患者分为RLUL组(n=40)与MPCNL组(n=44),比较2组患者围术期相关指标情况。采用SPSS 19.0统计软件进行数据分析。根据数据类型,分别采用t检验、χ^(2)检验或Fisher精确检验进行组间比较。结果RLUL组手术时间长于MPCNL组[(64.06±10.74)和(40.53±9.52)min],术后血红蛋白水平高于MPCNL组[(145.69±15.33)和(136.76±14.86)g/L],手术下床活动时间[(2.03±0.43)和(4.46±0.94)d]及引流管保留时间[(5.21±0.89)和(7.36±1.25)d]均短于MPCNL组,术后高热发生率低于MPCNL组(0.00%和13.64%),差异均有统计学意义(P<0.05)。2组患者结石清除率(100.00%和97.73%)、尿管保留时间[(5.46±1.07)和(5.71±1.32)d]及术后住院时间[(6.15±1.65)和(6.53±1.49)d]比较,差异均无统计学意义(P>0.05)。术后随访6~10(7.58±1.06)个月,2组均未见输尿管狭窄及结石复发情况。结论MPCNL与RLUL在治疗输尿管上段嵌顿性结石中均具有良好的效果且安全性较高,临床可结合患者具体病情选择合适的手术方式。
Objective To study the efficacy and safety of retroperitoneal laparoscopic ureterolithotomy(RLUL)and mini-percutaneous nephrolithotomy(MPCNL)in the treatment of upper ureteral calculi.Methods A retrospective analysis was made of the clinical data of 84 patients with upper ureteral calculi,who were treated at the Urology Department of Qionghai People′s Hospital from January 2021 to January 2022.According to the surgical interventions employed,they were divided into RLUL group(n=40)and MPCNL group(n=44).The two groups were compared in the perioperative indicators.SPSS statistics 19.0 was used for data analysis,and independent sample t test,χ^(2)test or Fisher exact test was performed for inter-group comparison,depending on data type.Results Compared with MPCNL group,the RLUL group had longer surgical time[(64.06±10.74)vs(40.53±9.52)min],higher hemoglobin level after surgery[(145.69±15.33)vs(136.76±14.86)g/L],shorter ambulation time[(2.03±0.43)vs(4.46±0.94)d]and retention time of drainage tube[(5.21±0.89)vs(7.36±1.25)d],and lower incidence of postoperative high fever(0.00%vs 13.64%),the difference being statistically significant(P<0.05).There were no statistical differences between the two groups in stone clearance rate(100.00%vs 97.73%),urethral catheter retention time[(5.46±1.07)vs(5.71±1.32)d]and postoperative hospital stay[(6.15±1.65)vs(6.53±1.49)d;P>0.05].No ureteral stricture or stone recurrence occurred in the two groups during post-operative follow-up of 6-10(7.58±1.06)months.Conclusion Both MPCNL and RLUL have good effects and high safety in the treatment of incarcerated upper ureteral calculi.It is recommended to select the appropriate surgical mode according to the specific conditions of patients.
作者
龙锦华
邓茂放
黄洪
Long Jinhua;Deng Maofang;Huang Hong(Department of Urology,Qionghai People′s Hospital,Qionghai 571400,Hainan Province,China)
出处
《中华老年多器官疾病杂志》
2023年第6期439-442,共4页
Chinese Journal of Multiple Organ Diseases in the Elderly
基金
琼海市科技计划项目(2020-13)。
