[1]陈广社 李锋.输尿管软镜与斜仰卧位微创经皮肾镜治疗输尿管上段结石的疗效比较[J].中华腔镜泌尿外科杂志(电子版),2015,(05):335-338.[doi:10.3877/cma.j.issn.1674-3253.2015.05.007 ]
　Chen Guangshe,Li Feng. Department of Emergeny,Department of General Surgery,et al.Comparison of flexible ureteroscopy and minimally invasive percutaneous nephrolithotomy in oblique supine position for proximal ureteral calculi[J].,2015,(05):335-338.[doi:10.3877/cma.j.issn.1674-3253.2015.05.007 ]
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输尿管软镜与斜仰卧位微创经皮肾镜治疗输尿管上段结石的疗效比较()
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中华腔镜泌尿外科杂志(电子版)[ISSN:1006-6977/CN:61-1281/TN]

卷:
期数:
2015年05期
页码:
335-338
栏目:
临床研究
出版日期:
2015-12-31

文章信息/Info

Title:
Comparison of flexible ureteroscopy and minimally invasive percutaneous nephrolithotomy in oblique supine position for proximal ureteral calculi
作者:
陈广社 1李锋 2
727000 陕西，铜川市人民医院（南院）急诊科1，普外科2
Author(s):
Chen Guangshe1;  Li Feng2. 1Department of Emergeny;  2Department of General Surgery;  the People's Hospital of Tongchuan City;  Shanxi 727000;  China
1.Department of Emergeny, 2.Department of General Surgery, the People's Hospital of Tongchuan City, Shanxi 727000, China
关键词:
输尿管结石; 输尿管软镜; 斜仰卧位; 肾造口术; 经皮
DOI:
10.3877/cma.j.issn.1674-3253.2015.05.007
摘要:
目的探讨输尿管软镜（ FURS）和斜仰卧位微创经皮肾镜（ MPCNL）治疗输尿管上段结石的疗效。方法选取 2010年 6月至 2014年 2月铜川市人民医院收治的输尿管上段结石患者 192例，随机分为 FURS组 98例和 MPCNL组 94例，结石直径 10~20 mm，均为单发。两组患者年龄、性别、结石直径、肾积水程度、体外冲击波碎石（ ESWL）无效比例等比较差异无统计学意义（ P>0.05）。观察指标包括手术时间、术后住院时间、清石率、术中出血 >400 ml例数、术中转开放手术例数、并发症发生率及术后发热例数，并分析结石成份。结果 FURS组和 MPCNL组手术时间分别为（ 65.7±16.8）min和（48.9±12.1）min，术后住院时间分别为（ 1.8±0.8）d和（ 4.6±1.3）d，两组间差异比较均具有统计学意义（P<0.01）； FURS组和 MPCNL组患者结石清除率分别为 84.6%和 94.7%，并发症（ Clavien分级 II级）发生率分别为 9.2%和 14.8%，差异均无统计学意义（ P>0.05）；此外，中转开放手术、出血 >400 ml及术后发热例数两组间比较差异均无统计学意义（ P>0.05）；结石成份分析显示，草酸钙结石所占比例最大，为 51.6%（99/192）。结论 FURS和斜仰卧位 MPCNL治疗输尿管上段结石都是安全有效的方法，斜仰卧位 MPCNL手术时间短，FURS取石术后患者恢复快。

参考文献/References:

[1] 李应忠 ,王健 ,佟发春 ,等.微创经皮肾镜碎石与输尿管镜碎石术治疗嵌顿性输尿管上段结石的疗效比较[J].中国微创外科杂志, 2014, 14(7): 631-633.
[2] 资小龙 ,阳旭明 ,陶学庭 ,等.输尿管软镜和微通道经皮肾镜碎石取石术治疗肥胖患者输尿管上段结石的对比分析[J].中国内镜杂志, 2014, 20(5): 544-547.
[3] 李涵,王坤杰,胡兴平.输尿管软镜与后腹腔镜治疗输尿管上段结石临床对照研究[J].实用医院临床杂志, 2014, 11(4): 48-51.
[4] 杨建军 ,杨关天 ,周齐军 ,等.组合式输尿管软镜治疗肾及输尿管上段结石[J].江苏医药, 2013, 39(17): 2065-2067.
[5] 尉春晓 ,陈修德 ,张安学 ,等.输尿管软镜钬激光碎石术治疗 ESWL失败后的输尿管上段结石 (附 15例报告 )[J].泌尿外科杂志:电子版, 2012, 4(3): 13-16.
[6] Kumar A, Nanda B, Kumar N, et al. A prospective randomized comparison between shockwave lithotripsy and semirigid ureteroscopy for upper ureteral stones< 2 cm: a single center experience[J]. J Endourol, 2015, 29(1): 47-51.
[7] 刘忠泽 ,李世俊 ,张福庆 ,等.微创经皮肾镜取石术手术并发症分析[J].中华泌尿外科杂志, 2006, 27(7): 447-449.
[8] Miernik A, Wilhelm K, Ardelt PU, et al. Standardized flexible ureteroscopic technique to improve stone-free rates [J]. Urology, 2012, 80(6): 1198-1202.
[9] Stern JM, Yiee J, Park S. Safety and efficacy of ureteral access sheaths[J]. J Endourol, 2007, 21(2): 119-123.
[10] Altunrende F, Tefekli A, Stein R J, et al. Clinically insignificant residual fragments after percutaneous nephrolithotomy: medium-term follow-up[J]. J Endourol, 2011, 25(6): 941-945.
[11] 王博涵,余脆,姚炜敏.微创经皮肾镜碎石术后临床无意义残石患者中期随访结果 [J].中华泌尿外科杂志 , 2012, 33 (7): 529-531.

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[11]陈文忠,钟文,曾国华,等.输尿管软镜钬激光碎石术治疗输尿管上段结石[J].中华腔镜泌尿外科杂志(电子版),2012,(04):278.
　CHEN Wen-zhong,ZHONG Wen,ZENG Guo-hua,et al.Flexible ureteroscopic Ho:YAG laser lithotripsy in treating upper ureteral stones[J].,2012,(05):278.

备注/Memo

备注/Memo:
通讯作者：陈广社，Email：yffs21@126.com
更新日期/Last Update: 1900-01-01