[1]熊 毅,廖泽茹.微创经皮肾镜取石术与经尿道输尿管镜钬激光碎石术治疗输尿管上段结石的效果比较[J].医学信息,2022,35(22):103-105.[doi:10.3969/j.issn.1006-1959.2022.22.021]
　XIONG Yi,LIAO Ze-ru.Effect Comparison of Minimally Invasive Percutaneous Nephrolithotomy and Transurethral Ureteroscopic Holmium Laser Lithotripsy in the Treatment of Upper Ureteral Calculi[J].Journal of Medical Information,2022,35(22):103-105.[doi:10.3969/j.issn.1006-1959.2022.22.021]
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微创经皮肾镜取石术与经尿道输尿管镜钬激光碎石术治疗输尿管上段结石的效果比较()
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医学信息[ISSN:1006-1959/CN:61-1278/R]

卷:
35卷
期数:
2022年22期
页码:
103-105
栏目:
论著
出版日期:
2022-11-15

文章信息/Info

Title:
Effect Comparison of Minimally Invasive Percutaneous Nephrolithotomy and Transurethral Ureteroscopic Holmium Laser Lithotripsy in the Treatment of Upper Ureteral Calculi
文章编号:
1006-1959（2022）22-0103-03
作者:
熊 毅; 廖泽茹
（瑞金市人民医院泌尿外科1，心血管内科2，江西 瑞金 342500）
Author(s):
XIONG Yi; LIAO Ze-ru
(Department of Urology1,Department of Cardiovascular2,People’s Hospital of Ruijin City,Ruijin 342500,Jiangxi,China)
关键词:
微创经皮肾镜取石术; 经尿道输尿管镜钬激光碎石术; 输尿管上段结石
Keywords:
Minimally invasive percutaneous nephrolithotomy; Transurethral ureteroscopic holmium laser lithotripsy; Upper ureteral calculi
分类号:
R693.4
DOI:
10.3969/j.issn.1006-1959.2022.22.021
文献标志码:
A
摘要:
目的 比较微创经皮肾镜取石术与经尿道输尿管镜钬激光碎石术在输尿管上段结石中的临床疗效。方法 选取2021年1月-2022年1月我院治疗的68例输尿管上段结石患者为研究对象，采用随机数字表法分为对照组和观察组，各34例。对照组采用经尿道输尿管镜钬激光碎石术治疗，观察组采用微创经皮肾镜取石术治疗，比较两组临床手术指标、血红蛋白下降值、炎性因子水平、结石清除率、并发症发生率、生活质量（SF-36）评分。结果 观察组手术时间短于对照组，术中出血量多于对照组、术后血尿持续时间、住院时间均长于对照组（P＜0.05）；观察组血红蛋白下降值大于对照组，CRP、IL-6均高于对照组（P＜0.05）；观察组结石清除率为94.12%，高于对照组的82.35%（P＜0.05）；两组并发症发生率比较，差异无统计学意义（P＞0.05）；两组治疗后SF-36评分高于治疗前，且观察组低于对照组（P＜0.05）。结论 微创经皮肾镜取石术与经尿道输尿管镜钬激光碎石术治疗输尿管上段结石均具有一定的效果，虽然经尿道输尿管镜钬激光碎石术创伤小，可提高患者生活质量，但结石清除率低，而微创经皮肾镜取石术结石清除率高、手术时间短。两种术式临床疗效存在差异，各有优劣势，临床应结合患者个体差异进行针对性选择。
Abstract:
Objective To compare the clinical efficacy of minimally invasive percutaneous nephrolithotomy and transurethral ureteroscopic holmium laser lithotripsy in the treatment of upper ureteral calculi.Methods A total of 68 patients with upper ureteral calculi treated in our hospital from January 2021 to January 2022 were selected as the research objects. They were divided into control group and observation group by random number table method, with 34 cases in each group. The control group was treated with transurethral ureteroscopic holmium laser lithotripsy, and the observation group was treated with minimally invasive percutaneous nephrolithotomy. The clinical operation index, hemoglobin decrease value, inflammatory factor level, stone clearance rate, complication rate and quality of life (SF-36) score were compared between the two groups.Results The operation time of the observation group was shorter than that of the control group, the intraoperative blood loss was more than that of the control group, the duration of postoperative hematuria and hospitalization time were longer than those of the control group (P<0.05). The decrease of hemoglobin in the observation group was greater than that in the control group, and CRP and IL-6 were higher than those in the control group (P<0.05). The stone clearance rate of the observation group was 94.12%, which was higher than 82.35% of the control group (P<0.05). There was no significant difference in the incidence of complications between the two groups (P>0.05). The SF-36 scores of the two groups after treatment were higher than those before treatment, and the observation group was lower than the control group (P<0.05).Conclusion Minimally invasive percutaneous nephrolithotomy and transurethral ureteroscopic holmium laser lithotripsy have certain effects in the treatment of upper ureteral calculi. Although transurethral ureteroscopic holmium laser lithotripsy has less trauma and can improve the quality of life of patients, the stone clearance rate is low, while minimally invasive percutaneous nephrolithotomy has high stone clearance rate and short operation time. There are differences in the clinical efficacy of the two surgical methods, and each has its advantages and disadvantages, clinical selection should be based on individual differences in patients.

参考文献/References:

[1]姜锡男,胡瑞洁,陈方敏,等.体外冲击波碎石术失败后行经皮肾镜、腹腔镜、输尿管硬镜取石术的疗效比较:8年以上的单中心研究[J].现代泌尿外科杂志,2018,23(3):181-186. [2]苗发陈,任庆芹,杨志国,等.三种腔镜手术治疗嵌顿性输尿管上段结石的疗效比较[J].中国基层医药,2016,23(17):2626-2628,2629.[3]黄遂斌,向威,黄韬,等.微创经皮肾镜技术与 F-URS 治疗老年复杂输尿管上段结石的效果评价[J].实用临床医药杂志,2017,21(11):141-142. [4]蒋立桂,孟峻嵩,王美才,等.输尿管镜钬激光、经皮肾镜、后腹腔镜下输尿管切开三种取石术治疗复杂性输尿管上段结石的对照研究[J].国际泌尿系统杂志,2018,38(6):941-944. [5]潘东山,杨水法,杨恩明,等.三种微创方式治疗嵌顿性输尿管上段结石的疗效[J].中国实用医刊,2018,45(14):62-65.[6]王跃,曹沪春,陈启平,等.输尿管上段嵌顿性结石的三种微创手术疗效分析[J].中华腔镜泌尿外科杂志,2019,13(4): 267-270. [7]石奇刚,孙永恒,任艳胜.微创经皮肾镜取石术治疗输尿管上段结石合并轻度肾积水疗效观察[J].新乡医学院学报,2017,34(3):235-237. [8]杨梓光.微创经皮肾镜取石术和经尿道输尿管镜碎石取石术治疗输尿管上段嵌顿性结石的临床疗效观察[J].现代诊断与治疗,2016,27(7):1304-1306. [9]李强,王胜.经皮肾输尿管镜取石术治疗复杂性输尿管上段结石的疗效观察[J].微创医学,2016,11(5):751-752.[10]邹火生,黄裕清,余自强.经尿道输尿管镜碎石和微创经皮肾镜取石治疗输尿管上段嵌顿性结石的疗效比较[J].海南医学,2016,27(17):2853-2854．[11]邓青富,姜睿,裴利军,等.电子输尿管软镜与微创经皮肾镜碎石术治疗肾结石的比较[J].实用医学杂志,2016,32(5):721-723.[12]鲁成军,王亦农,田金波,等.三种微创碎石术治疗复杂性输尿管上段结石的临床对比研究[J].腹腔镜外科杂志,2017,22(7):501-504.[13]王斌,孙强.硕通镜与输尿管镜治疗输尿管上段结石的临床疗效对比[J].黑龙江中医药,2021,50(2):23-24.[14]何跃,奉友刚,何俊,等.经皮肾镜微通道气压弹道碎石和输尿管软镜钬激光碎石治疗输尿管上段嵌顿性结石的疗效比较[J].四川医学,2016,37(3):329-331.[15]李壮志.不同微创取石术式治疗复杂性输尿管上段结石近远期疗效、安全性及经济性比较[J].微创泌尿外科杂志,2016,5(4):209-212.[16]李超,徐鹏程,葛庆生,等.输尿管镜钬激光碎石术与经皮肾镜碎石取石术治疗复杂性输尿管上段结石的疗效比较[J].中国临床保健杂志,2017,20(5):555-558.[17]彭辉,吴鹏,贲亮亮,等.输尿管软镜下钬激光碎石治疗输尿管上段结石对机体应激反应的影响[J].现代仪器与医疗,2017,23(6):91-92,108[18]汪珂,何建光,张刘勇.输尿管软镜钬激光碎石术对上尿路结石患者结石清除率及并发症的影响[J].贵州医药,2019,43(3):101-102.

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更新日期/Last Update: 1900-01-01