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目的比较输尿管镜下钬激光碎石术与腹腔镜输尿管切开取石术治疗输尿管结石的临床疗效。方法中上段输尿管结石患者130例,分别采用输尿管镜下钬激光碎石术(输尿管镜组,65例)和腹腔镜输尿管切开取石术(腹腔镜组,65例),比较两组疗效。结果与腹腔镜组比较,输尿管镜组手术时间和住院时间短[(42.44±6.83)min vs.(57.31±5.11)min和(5.12±0.78)d vs.(9.53±1.13)d],但即刻清石率低(79.22%vs.93.28%)(P<0.05)。治疗后12h和24h,腹腔镜组患者WBC、中性粒细胞比例和C反应蛋白水平低于输尿管镜组(P<0.05),并发症发生率也较低(4.62%vs.16.92%)(P<0.05)。结论与输尿管镜下钬激光碎石术比较,腹腔镜切开取石术具有即刻清石率高和并发症发生率低的优点。
Objective To compare the clinical efficacy of ureteroscopic holmium laser lithotripsy and laparoscopic ureterolithotomy for the treatment of ureteral calculi. Methods 130 cases of upper ureteral calculi were treated with ureteroscopic holmium laser lithotripsy (ureteroscopy group, 65 cases) and laparoscopic ureterolithotomy (laparoscopic group, 65 cases). The curative effect was compared between the two groups. Results Compared with laparoscopic group, operative time and hospitalization time in ureteroscopy group were shorter than those in laparoscopic group [(42.44 ± 6.83) min vs. (57.31 ± 5.11) min vs (5.12 ± 0.78) d vs. (9.53 ± 1.13) d] Clearance rate was low (79.22% vs.93.28%) (P <0.05). The levels of WBC, neutrophil and C-reactive protein were lower in the laparoscopic group than in the ureteroscopy group (P <0.05) at 12h and 24h after treatment, and the incidence of complications was also lower (P <0.05) <0.05). Conclusions Compared with ureteroscopic holmium laser lithotripsy, laparoscopic lithotomy has the advantages of immediate high rate of stone removal and low complication rate.