[1]杨登科,陈书奎,焦湘,等.不同微创方法治疗输尿管上段结石的比较分析[J].中华腔镜泌尿外科杂志(电子版),2010,(01):49-53.
　YANG Deng-ke,CHEN Shu-kui,JIAO Xiang,et al.Comparative study of different minimally invasive methods for the treatment of upper ureter calculi[J].,2010,(01):49-53.
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不同微创方法治疗输尿管上段结石的比较分析()
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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:
2010年01期
页码:
49-53
栏目:
出版日期:
1900-01-01

文章信息/Info

Title:
Comparative study of different minimally invasive methods for the treatment of upper ureter calculi
作者:
杨登科; 陈书奎; 焦湘; 孔令军; 闫俊岭; 郭大勇
解放军第159中心医院泌尿外科,河南驻马店,463000
Author(s):
YANG Deng-ke; CHEN Shu-kui; JIAO Xiang; KONG Ling-jun; YAN Jun-ling; GUO Da-yong
关键词:
输尿管结石; 气压弹道碎石; 钬激光; 后腹腔镜; 微创经皮肾镜碎石术
摘要:
目的 总结比较不同微创方法治疗输尿管上段结石的效果.方法 分析不同微创方法治疗488例输尿管上段结石的临床资料.其中输尿管镜气压弹道碎石组129例,后腹腔镜输尿管切开取石组25例,输尿管镜钬激光碎石组91例,微创经皮肾镜取石(MPCNL)243 例.各组年龄、性别、结石大小和结石停留时间无统计学差异.分析各组手术时间、血红蛋白下降值、住院天数、碎石成功率、结石排尽率和并发症发生率等指标.结果 各组手术时间有统计学差异(p=0.000),后腹腔镜组手术时间84.76±11.32min最长,气压弹道碎石组28.45±8.96min和钬激光碎石组30.80±7.80min较短,两组间无统计学差异(p=0.095);住院天数后腹腔镜组7.81±1.36d和MPCNL组7.67±1.26d均显著长于气压弹道组3.44±0.99d(p=0.000,P=0.000)与钬激光组3.58±1.15d(p=0.000,P=0.000),后腹腔镜组与MPCNL组间(p=0.473)、气压弹道组与钬激光组间(p=0.275)无统计学差异;术后血红蛋白下降值后腹腔镜组显著高于其他三组(p=0.000,P=0.000,P=0.000),气压弹道组和钬激光组间无统计学差异(p=0.352).后腹腔镜组、mPCNL组碎石成功率和术后结石排尽率均为100%.气压弹道组手术成功率和结石排尽率分别为93.79%(121/129)和92.24%(119/129),均显著低于钬激光组(p=0.041,P=0.037).后腹腔镜组并发症发生率为16.00%(4/25),显著高于气压弹道碎石组(5.42%)(p=0.027)和钬激光组(4.39%)(p=0.044).MPCNL组并发症发生率(11.10%)与后腹腔镜组16.00%无显著性差异(p=0.463),但显著高于气压弹道碎石组(p=0.045)和钬激光组(p=0.046),气压弹道碎石组与钬激光碎石组间无统计学差异(p=0.733).结论 对于输尿管上段较大结石、结石停留时间较长者宜首选MPCNL;如采用输尿管镜下碎石,钬激光碎石效果优于气压弹道碎石;对于MPCNL和输尿管镜下碎石失败的病例可采用后腹腔镜下输尿管切开取石.

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更新日期/Last Update: 1900-01-01