腹腔镜输尿管切开取石与经皮肾镜碎石术治疗输尿管上段复杂结石的

·论著·

SYSTEMS MEDICINE 系统医学系统医学2019年6月第4卷第12期

DOI:10.19368/https://www.360docs.net/doc/5d7671784.html,ki.2096-1782.2019.12.007腹腔镜输尿管切开取石与经皮肾镜碎石术治疗

输尿管上段复杂结石的临床疗效评价

扈云喜

山东省济宁市汶上县人民医院泌尿外科,山东济宁272501

[摘要]目的研究输尿管上段复杂结石患者实施腹腔镜输尿管切开取石术的临床疗效。方法选择68例于该院接受输尿管上段复杂结石治疗的患者,纳入时间为2015年12月—2018年12月,采用随机数字表法将其分为实验组与参照组,每组均34例。其中参照组采用经皮肾镜碎石术,实验组行腹腔镜输尿管切开取石术,对比两组患者手术相关指标、术后并发症及结石清除情况。结果实验组手术时间、下床时间、导尿管拔除时间、引流时间、住院时间、出血量分别为(49.86±14.25)min、(2.17±0.42)d、(2.97±0.46)d、(4.51±1.28)d、(5.29±1.84)d、(52.43±8.23)mL;参照组分别为(88.74±21.59)min、(2.19±0.45)d、(2.96±0.42)d、(4.48±1.30)d、(5.32±1.86)d、(52.39±8.27)mL (t=8.7637、0.1894、0.0936、0.0958、0.0668、0.0199;P=0.0000、0.8503、0.9257、0.9239、0.9468、0.9841)。实验组手术时间均短于参照组,组间呈差异有统计学意义(P<0.05),两组患者下床时间、导尿管拔除时间、引流时间、住院时间、出血量差异无统计学意义(P>0.05)。实验组发热、切口感染、尿漏分别为2、1、1例,总并发症4例,占比11.76%,参照组分别为1、1、1例,总并发症3例,占比8.82%(χ2=0.1592,P=0.6898)。两组发热、切口感染、尿漏等术后并发症发生比例(11.76%、8.82%)差异无统计学意义(P>0.05)。两组输尿管上段复杂结石清除率(97.06%、94.12%)差异无统计学意义(χ2=0.3487,P=0.5548,>0.05)。结论输尿管上段复杂结石患者通过腹腔镜输尿管切开取石与经皮肾镜碎石术治疗效果相当,且手术安全性水平一致,但腹腔镜输尿管切开取石术手术时间较短,

临床中可根据患者实际情况予以选择。

[关键词]输尿管上段复杂结石;腹腔镜输尿管切开取石术;经皮肾镜碎石术

[中图分类号]R699[文献标识码]A [文章编号]2096-1782(2019)06(b)-0007-03Clinical Evaluation of Laparoscopic Ureterolithotomy and Percutaneous Nephrolithotomy in the Treatment of Complex Upper Ureteral Calculi HU Yun-xi

Department of Urology,Wenshang County People's Hospital,Jining,Shandong Province,272501China [Abstract]Objective To study the clinical effect of laparoscopic ureterolithotomy in patients with complex upper ureteral calculi.Methods A total of 68patients with complex upper ureteral calculi in our hospital were enrolled from December 2015to December 2018.They were divided into experimental group and control group by random number table method,34cases in each group.The reference group was treated with percutaneous nephrolithotomy,and the ex?perimental group was treated with laparoscopic ureterolithotomy.The operative parameters,complications and stone clearance were compared between the two groups.Results The operative time,bed time,catheter extraction time,drainage time,hospitalization time and blood loss in the experimental group were (49.86±14.25)min,(2.17±0.42)d,(2.97±0.46)d,(4.51±1.28)d,(5.29±1.84)d,(52.43±8.23)mL,respectively.The data in the control group were (88.74±21.59)min,(22.19±0.45)d,(2.96±0.42)d,(4.48±1.30)d,(5.32±1.86)d,(52.39±8.27)mL(t=8.7637,0.1894,0.0936,0.0958,0.0668,0.0199.P=0.0000,0.8503,0.9257,0.9239,0.9468,0.9841).The operation time of the experi?mental group was shorter than that of the reference group,and there were statistically significant differences between the two groups (P<0.05).There was no statistically significant difference between the two groups in bed time,catheter

removal time,drainage time,hospitalization time,and blood loss (P>0.05).In the experimental group,there were 2cas?[作者简介]扈云喜(1978-),男,山东济宁人,本科,主治医

师,研究方向:泌尿外科微创治疗。