黃麗平 楊鵜 何劍

[摘要] 目的 探討不同手術(shù)方式治療輸尿管結(jié)石的效果。 方法 方便選取2017年3月—2018年6月貴陽(yáng)醫(yī)學(xué)院第二附屬醫(yī)院收治的90例輸尿管結(jié)石患者，隨機(jī)分為研究組和對(duì)照組。對(duì)照組采用腹腔鏡下輸尿管切開取石術(shù)治療。研究組采用輸尿管鏡下鈥激光碎石術(shù)治療。記錄兩組的手術(shù)時(shí)間、手術(shù)失血、 總住院天數(shù)。記錄兩組的首次碎石成功、二次手術(shù)、結(jié)石清除情況。對(duì)比兩組的并發(fā)癥發(fā)生率。 結(jié)果 研究組的手術(shù)時(shí)間（38.15±5.49）min vs （52.08±6.72）min、手術(shù)失血（13.25±3.14）mL vs （41.09±6.53）mL、 總住院天數(shù)（3.74±0.85）d vs （6.95±1.34）d低于對(duì)照組，差異有統(tǒng)計(jì)學(xué)意義（t=10.769、25.775、13.570，P<0.05）；研究組的首次碎石成功（77.78% vs 93.33%）、結(jié)石清除（20.00% vs 2.22%）低于對(duì)照組，但二次手術(shù)率（82.22% vs 97.78%）比對(duì)照組高，差異有統(tǒng)計(jì)學(xué)意義（P<0.05）；研究組的并發(fā)癥發(fā)生率低于對(duì)照組（11.11% vs 26.67%），差異有統(tǒng)計(jì)學(xué)意義（P<0.05）。 結(jié)論 腹腔鏡下輸尿管切開取石術(shù)具有結(jié)石清除率高、并發(fā)癥高的特點(diǎn)，輸尿管鏡下鈥激光碎石術(shù)具有手術(shù)時(shí)間短、出血量低、恢復(fù)快、并發(fā)癥少等特點(diǎn)，但結(jié)石清除率較低，需進(jìn)行二次手術(shù)率較高。

[關(guān)鍵詞] 腹腔鏡下輸尿管切開取石術(shù)；輸尿管鏡下鈥激光碎石術(shù)；輸尿管結(jié)石

[中圖分類號(hào)] R699.4 [文獻(xiàn)標(biāo)識(shí)碼] A [文章編號(hào)] 1674-0742（2019）01（c）-0057-03

Analysis of the Effect of Different Surgical Methods in the Treatment of Ureteral Calculi

HUANG Li-ping1， YANG Ti1， HE Jian2

1.Southeast National Vocational and Technical College of Guizhou， Kaili， Guizhou Province， 556000 China； 2.The Second Affiliated Hospital of Guiyang Medical College， Kaili， Guizhou Province， 556000 China

[Abstract] Objective To investigate the effect of different surgical methods on ureteral calculi. Methods 90 patients with ureteral calculi admitted to the Second Affiliated Hospital of Guiyang Medical College from March 2017 to June 2018 were convenient divided into study group and control group. The control group was treated with laparoscopic ureterolithotomy. The study group was treated with ureteroscopic holmium laser lithotripsy. The operation time， blood loss， and total hospital stay were recorded in the two groups. The first successful lithotripsy， secondary surgery， and stone removal were recorded. The incidence of complications was compared between the two groups. Results The operation time of the study group （38.15±5.49）min vs （52.08±6.72）min， surgical blood loss （13.25±3.14）mL vs （41.09±6.53）mL， and total hospital stay （3.74±0.85）d vs （6.95±1.34）d were lower than the control group. The difference was statistically significant （t=10.769， 25.775， 13.570， P<0.05）； the first successful lithotripsy （77.78% vs 93.33%） and stone clearance （20.00% vs 2.22%） in the study group were lower than the control group， but the rate of secondary operation （82.22% vs 97.78%） was higher than that of the control group， and the difference was statistically significant （P<0.05）. The complication rate of the study group was lower than that of the control group （11.11% vs 26.67%）. The difference was statistically significant （P<0.05）. Conclusion Laparoscopic ureterolithotomy has the characteristics of high stone clearance rate and high complications. Ureteroscopic holmium laser lithotripsy has the characteristics of short operation time， low blood loss， quick recovery and less complications， but the stone removal rate is lower and the rate of secondary surgery needs to be higher.