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目的:评价经皮肾镜取石术(PCNL)治疗>1.5cm输尿管上段结石的安全性和有效性。方法:2014年7月~2016年3月我院收治输尿管上段结石直径>1.5cm的患者133例,52例接受PCNL,81例接受输尿管镜碎石术(URL)。对比分析两组患者资料。结果:多项观察指标在两组间的差异有统计学意义:PCNL和URL的术后清石率分别为92.3%和75.3%(P=0.013);两组患者平均手术时间分别为(37.6±13.8)min和(44.1±12.5)min(P=0.006);PCNL及URL平均Hb减少量分别为(8.06±8.1)g/L和(4.8±5.4)g/L(P=0.006);术后平均住院时间分别为(5.4±1.9)d和(2.0±1.3)d(P<0.01);两组患者的再次治疗率分别为3.8%和16.0%(P=0.030)。两组患者并发症发生率之间差异无统计学意义,分别为13.5%和19.8%(P=0.349)。结论:PCNL治疗直径>1.5cm输尿管上段结石安全有效,手术时间短,清石率高,再治疗率低。
Objective: To evaluate the safety and efficacy of percutaneous nephrolithotomy (PCNL) in the treatment of upper ureteral calculi> 1.5cm. Methods: From July 2014 to March 2016, 133 cases of patients with ureteral calculi larger than 1.5 cm in diameter were enrolled in our hospital. Fifty-two patients received PCNL and 81 received ureteroscopic lithotripsy (URL). Comparative analysis of two groups of patient data. Results: The differences between the two groups were statistically significant. The postoperative rates of PCNL and URL were 92.3% and 75.3%, respectively (P = 0.013). The average operative time was (37.6 ±) (8.06 ± 8.1) g / L and (4.8 ± 5.4) g / L, respectively (P = 0.006). The average Hb decrease in PCNL and URL was (13.8) min and (44.1 ± 12.5) min respectively The average duration of hospital stay was (5.4 ± 1.9) days and (2.0 ± 1.3) days (P <0.01). Re-treatment rates for both groups were 3.8% and 16.0%, respectively (P = 0.030). There were no significant differences in the incidence of complications between the two groups, 13.5% and 19.8%, respectively (P = 0.349). Conclusion: PCNL is safe and effective in the treatment of upper ureteral calculi> 1.5cm in diameter. The operation time is short, the rate of clear stone is high and the rate of re-treatment is low.