摘要
目的对比经皮肾穿刺取石术(MPCNL)与经尿道输尿管镜碎石术(URL)在治疗输尿管上段嵌顿性结石的疗效差异以及安全性,并探讨其对血清C反应蛋白的影响,为临床手术方式的选择提供参考。方法选取170例输尿管上段嵌顿性结石患者。随机分为URL组和MPCNL组各85例。URL组采用经尿道输尿管镜碎石术,MPCNL组采用经皮肾穿刺取石术,比较两组患者的手术时间、术后住院时间、结石清除率、血红蛋白、血清C反应蛋白的变化以及并发症。结果 URL组患者的手术时间明显长于MPCNL组;URL组患者术后的住院时间较MPCNL组明显缩短;MPCNL组患者术后3d以及术后1个月的结石清除率均明显高于URL组;URL组的血红蛋白仅出现轻微的下降,其下降的幅度明显低于MPCNL组;差异均有统计学意义(P<0.05)。两组患者在手术前1d及手术后各个时间段的血清CRP比较,差异无统计学意义(P>0.05)。URL组并发症发生率为8.24%,MPCNL组并发症发生率为5.88%,差异无统计学意义(P>0.05)。结论两种手术方式治疗输尿管上段嵌顿性结石各有优势,但对患者的创伤程度差异无统计学意义。临床上应该根据患者的病情特点综合评估,采用更加合适的手术方式进行治疗。
Objective To compare the clinical effect of different operation mode in the treatment of impact- ed upper ureteric calculi and their effect on serum C reaction protein, and to provide the reference for the clinical selec- tion. Methods One hundred and seventy patients with impacted upper ureteral calculi were randomly divided into URL group and MPCNL group, with 85 cases in each group. The patients in URL group were treated with transure- thral ureteroscopic lithotripsy, while those in MPCNL group were treated with percutaneons nephrolithotomy. The op- eration time, hospitalization time, stone-free rate, hemoglobin and complications of the two groups were compared. Results The operation time of URL group were significantly longer than that of MPCNL group, and the hospitaliza- tion time of URL group was significantly shorter than that of MPCNL group. The stone-free rate of MPCNL group was significantly higher than that og URL group. The concentration of hemoglobin in URL group showed on- ly a slight decline, the decline rate was significantly lower than that in MPCNL group （P〈0.05）. The inci- dence rate of URL group was 8.24%, while it was 5.88% in MPCNL group, showing no statistically signifi- cant difference （P〉0.05）. Conclusion In the treatment of impacted upper ureteral stones, the two kinds of opera- tion methods have their own advantages. The operation mode should be adopted based on the clinical characteristics of patients and the comprehensive evaluation of the disease.
出处
《海南医学》
CAS
2013年第13期1907-1910,共4页
Hainan Medical Journal
关键词
经皮肾穿刺取石
经尿道输尿管镜碎石
嵌顿性输尿管上段结石
疗效
Percutaneous nephrolithotomy
Transurethral ureteroscopic lithotripsy
Impacted upper ureteric calculi
Curative effect
