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目的探讨经皮肾穿刺碎石取石术(PCNL)与经尿道输尿管镜碎石术(URL)上段结石的疗效和优劣点。方法 226例输尿管上段结石患者,行URL118例,PCNL108例。结果 URL组118例完成碎石115例,改开放手术3例,结石最大经平均10.8mm,手术平均时间35min,术后平均住院时间4d,结石一次清除98例(83%)。PCNL组108例,完成碎石清石107例,改开放手术1例,结石最大经平均14.5mm,手术时间平均40min,术后平均住院时间7d,结石一次清除105例(97.2%)。结论 PCNL和URL治疗输尿管上段结石各有自己的优劣点,根据具体病例选用,能保证结石清除率和降低并发症发生率。
Objective To investigate the clinical effects and advantages and disadvantages of percutaneous nephrolithotomy (PCNL) and transurethral ureteroscopic lithotripsy (URL). Methods A total of 226 patients with upper ureteral calculi underwent 116 cases of URL and 108 cases of PCNL. Results In the URL group, 115 cases of complete gravel were completed, 3 cases were changed to open operation, the largest average diameter was 10.8 mm, average operation time was 35 minutes, average postoperative hospital stay was 4 days, and stones were removed in 98 cases (83%). In the PCNL group, 107 cases were completed lithotripsy, one case was changed to open surgery, the largest was 14.5 mm, the average operation time was 40 minutes, the average hospitalization time was 7 days, and the stones were removed in 105 cases (97.2%). Conclusion PCNL and URL in the treatment of upper ureteral calculi have their own advantages and disadvantages, according to the selection of specific cases, to ensure the stone removal rate and reduce the incidence of complications.