论文部分内容阅读
目的探讨输尿管镜下碎石术治疗嵌顿性输尿管上段结石的术式选择方法。方法对187例单侧嵌顿性输尿管上段结石患者,根据结石的大小、输尿管梗阻情况、肾积水轻重、肾盂肾盏发育情况,选择不同的手术方法。62例采用MPCNL治疗;125例采用URL治疗,其中33例术后辅助ESWL治疗。结果MPCNL组术后3天结石清除率95.2%(59/62),术后1个月结石清除率100%(62/62);URL组术后3天结石清除率36.8%(37/125),显著低于MPCNL组(p<0.01),术后1个月结石清除率98.4%(123/125),与MPCNL组相比差异无显著性(p>0.05)。结论MPCNL治疗嵌顿性输尿管上段结石有较高的结石清除率,URL效果稍差,但通过对不同情况的结石进行选择,配合ESWL可明显提高疗效。
Objective To investigate the surgical selection of ureteroscopic lithotripsy for upper ureteral calculi. Methods 187 cases of unilateral ureteral calculi in patients with upper ureteral stones, according to the size of stones, ureteral obstruction, hydronephrosis severity, pyelonephrosis development, choose a different surgical methods. 62 cases were treated with MPCNL; 125 cases were treated with URL, and 33 cases were assisted by ESWL after operation. Results The stone clearance rate was 95.2% (59/62) in 3 days after operation in MPCNL group, and stone clearance rate was 100% (62/62) in 1 month after operation. The stone clearance rate in 36 days was 36.8% (37/125) , Significantly lower than that of MPCNL group (p <0.01). The stone clearance rate at one month after operation was 98.4% (123/125). There was no significant difference between MPCNL group and MPCNL group (p> 0.05). Conclusion MPCNL treatment of upper ureteral calculi stones have a higher rate of stone clearance, URL effect is slightly worse, but through the choice of stones in different situations, with ESWL can significantly improve the efficacy.