[1]刘余庆,卢剑,肖春雷,等.微创经皮肾镜与后腹腔镜治疗嵌顿性输尿管上段结石的比较研究[J].中国微创外科杂志,2009,09(7):626-629.
　Liu Yuqing,Lu Jian,Xiao Chunlei,et al.Comparison between Minimally Invasive Percutaneous Nephrolithotomy and Retroperitoneal Laparoscopic Ureterolithotomy for Impacted Upper Ureteral Calculi[J].Chinese Journal of Minimally Invasive Surgery,2009,09(7):626-629.
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微创经皮肾镜与后腹腔镜治疗嵌顿性输尿管上段结石的比较研究()
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《中国微创外科杂志》[ISSN:1009-6604/CN:11-4526/R]

卷:
09
期数:
2009年7期
页码:
626-629
栏目:
出版日期:
2009-08-25

文章信息/Info

Title:
Comparison between Minimally Invasive Percutaneous Nephrolithotomy and Retroperitoneal Laparoscopic Ureterolithotomy for Impacted Upper Ureteral Calculi
作者:
刘余庆; 卢剑; 肖春雷; 侯小飞; 黄毅; 马潞林
北京大学第三医院泌尿外科，北京100191
Author(s):
Liu Yuqing;  Lu Jian;  Xiao Chunlei;  et al.
Department of Urology, Peking University Third Hospital, Beijing 100191, China
关键词:
输尿管结石; 经皮肾取石术; 腹腔镜; 腹膜后
Keywords:
Ureteral calculi; Percutaneous nephrolithotomy; Laparoscopy; Retroperitoneal
分类号:
R693+.4
文献标志码:
A
摘要:
目的比较微创经皮肾镜取石术（minimally invasive percutaneous nephrolithotomy，MPCNL）与后腹腔镜输尿管切开取石术（retroperitoneal laparoscopic ureterolithotomy，RLUL）治疗嵌顿性输尿管上段结石的有效性及安全性。 方法2003年9月～2008年6月，对73例伴有肾积水的单侧嵌顿性输尿管上段结石，46例采用MPCNL治疗（MPCNL组），27例采用RLUL治疗（RLUL组），比较2组的结石清除率及手术并发症。 结果RLUL组手术时间为（92.6±23.3）min，显著长于MPCNL组的（66.7±20.3）min（t=-4.967，P=0.000）。术后3 d的结石清除率MPCNL组为93.5%（43/46），RLUL组为100.0%（27/27），差异无显著性（χ2=0.554，P=0.457）。术后3 d血红蛋白下降MPCNL组为（0.59±0.30）g/L，显著高于RLUL组的（0.38±0.21）g/L（t=3.223，P=0.002）。术后MPCNL组有4例（8.7%）出现38.5 ℃以上发热，与RLUL组1例（3.7%）差异无显著性（χ2=0.112，P=0.737）。术后RLUL组有1例（3.7%）尿漏，与MPCNL组（0/46）差异无显著性（χ2=0.074，P=0.786）。结论MPCNL与RLUL在治疗嵌顿性输尿管上段结石上都具有满意的疗效与安全性，RLUL术中出血较少，但手术时间长，在有条件且技术成熟的医院可适当开展。
Abstract:
ObjectiveTo compare the efficacy and safety of minimally invasive percutaneous nephrolithotomy (MPCNL) and retroperitoneal laparoscopic ureterolithotomy (RLUL) for impacted upper ureteral calculi. MethodsFrom September 2003 to June 2008, a total of 73 patients with unilateral impacted upper ureteral calculi complicated with hydronephrosis were treated in our hospital. Among the patients, 46 patients received MPCNL (MPCNL Group), and the other 27 patients underwent RLUL (RLUL Group). The rates of stone clearance and operative complications were analyzed.ResultsThe mean operation time in RLUL group was (92.6±23.3) min, which was significantly longer than that of MPCNL group ［(66.7±20.3) min, t=-4.967, P=0.000). On the day 3 after the surgery, no marked difference was detected in the stone clearance rate between the two groups ［MPCNL group: 93.5% (43/46) vs RLUL Group: 100.0% (27/27); χ2=0.554, P=0.457］. As compared with the RLUL Group, the MPCNL Group showed a significantly reduction of mean blood hemoglobin concentration on the third day after the operations ［MPCNL group:(0.59±0.30) g/L vs RLUL group: (0.38±0.21) g/L, t=3.223, P=0.002). The incidences of postoperative hyperpyrexia (T>385 ℃) and urine leakage were similar between the two groups ［8.7% (4/46) vs 3.7% (1/27), χ2=0.112, P=0.737; and 0 (0/46) vs 37% (1/27), χ2=0.074, P=0.786］.ConclusionsBoth MPCNL and RLUL are effective and safe for impacted upper ureteral calculi. RLUL, which results in less blood loss but longer operation time, is feasible in advanced hospitals.

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更新日期/Last Update: 2013-09-17