不同手术方式治疗复杂性输尿管上段结石的疗效比较

目的：比较输尿管镜碎石术、微创经皮肾镜取石术的疗效。方法共纳入70例复杂性输尿管上段结石患者，其中A组32例行微创经皮肾镜取石术（minimally invasive percutaneous nephrolithotomy，MPCNL），B组38例行输尿管镜碎石术（ureteroscopic lithotripsy，URL），观察两组患者术后的成功率、手术时间、出血量、住院时间及并发症发生率。结果 A组的成功率显著高于B组，差异有统计学意义（P〈0.05）；B组手术时间（39.1±8.3）min，显著短于A组（P〈0.01）；B组出血量（10.1±2.4）mL，显著少于A组（P〈0.01）；B组住院时间（6.79±1.77）d，明显短于A组（P〈0.01）；B组并发症发生率显著低于A组（P〈0.05）。结论输尿管镜碎石术、微创经皮肾镜取石术各具优势，临床医生可根据患者实际情况进行最佳选择。

The efficacy comparison of different surgical methods in treatment of complicated ureteral calculi

Objective To compare efficacy of ureteroscopy, minimally invasive percutaneous nephrolithotomy surgery. Methods A total of 70 cases of patients with ureteral stones,A group underwent MPCNL 32 cases,group B underwent URL 38 cases, the success rate after treatment, surgical time, blood loss, hospital stay and complication rates were compared. Results The success rate of group A was significantly higher than group B,the difference was significant（P〈0.05）. Group B of operative time（39.1＆#177;8.3）min, was significantly shorter in group A（P〈0.01）. Group B of bleed-ing（10.1＆#177;2.4）mL, was significantly less than group A（P〈0.01）. Group B of hospital stay was（6.79＆#177;1.77）d, was signifi-cantly shorter than group A,the difference was significant （P〈0.01）. The complication rate of B group was significantly lower than group A（P〈0.05）. Conclusion Ureteroscopy, minimally invasive percutaneous nephrolithotomy surgery respec-tive advantages, clinicians may be the best choice based on the actual situation of the patient.