| 嵌顿性输尿管上段结石三种微创术式的疗效比较 |
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| 引用本文： | 陈兴屹,温晓飞,仇广明,温机灵,陆佳荪,张国强,杨波,王跃闽.嵌顿性输尿管上段结石三种微创术式的疗效比较[J].中华腔镜泌尿外科杂志（电子版）,2010,4(1):23-26. |
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| 作者姓名： | 陈兴屹 温晓飞 仇广明 温机灵 陆佳荪 张国强 杨波 王跃闽 |
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| 作者单位： | 上海同济大学附属东方医院泌尿外科,200120 |
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| 摘 要： | 目的比较微创经皮肾穿刺取石术(MPCNL)、经尿道输尿管镜碎石术(URL)以及后腹腔镜输尿管切开取石术(RPLU)治疗嵌顿性输尿管上段结石的疗效。方法140例单侧嵌顿性输尿管上段结石患者,URL组55例,MPCNL组48例,RPLU组37例。术后辅助体外冲击波碎石(ESWL)治疗,其中URL组25例,MPCNL组1例,RPLU组无。术后3d及1个月后统计结石清除率。结果MPCNL组术后3d结石清除率为94%(45/48),术后1个月结石清除率为100%(48/48)。URL组术后3d结石清除率为56%(31/55),术后1个月结石清除率86%(47/55),RPLU组1例因结石上移改开放手术取石成功,术后3d结石清除率为97%(35/36),术后1个月结石清除率100%(37/37),三组并发症发生率无统计学差异。结论对于输尿管上段嵌顿结石,如结石体积较大,肾积水较明显且结石位置接近肾盂者,更适合选择MPCNL治疗;如结石位置偏低,积水较少以及不适宜全麻的患者,或患者主动要求可考虑经尿道输尿管镜手术;对于合适选择性的病例,可行腹腔镜手术,同时可作为经尿道输尿管镜手术失败的补救治疗措施。
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| 关 键 词： | 输尿管结石 输尿管镜 经皮肾镜取石术 腹腔镜 |
The comparison of three kinds of minimally invasive lithotripsy for treatment of impacted upper ureteric calculi |
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| Authors: | CHEN Xing-yi WEN Xiao-fei CHOU Guang-ming WEN Ji-ling LU Jia-sun ZHANG Guo-qiang YANG Bo WANG Yue-min |
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| Affiliation: | CHEN Xing-yi,WEN Xiao-fei,CHOU Guang-ming,WEN Ji-ling,LU Jia-sun,ZHANG Guo-qiang,YANG Bo,WANG Yue-min. Department of Urology,Shanghai East Hospital of Tongji University,Shanghai 200120,China |
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| Abstract: | Objective To investigate the effect of the minimally invasive percutaneous nephrolithotomy (MPCNL) in management of impacted upper ureteric calculi, comparing with transurethral ureteroscope lithotripsy (URL) and retroperitoneal laparoscopic ureterolithotomy (RPLU). Methods A total of 140 patients were enrolled the study. 55 patients received URL, 48 patients received MPCNL, while 37 patients received RPLU. There were 25 patients needed auxiliary extracorporeal shock wave lithotripsy(ESWL) after URL, and 1 ... |
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| Keywords: | Ureteric calculi Ureterscope Percutaneous nephrolithotomy Laparoscopy |
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