嚴(yán)全華

[摘要]目的 探討微通道經(jīng)皮腎鏡與后腹腔鏡治療嵌頓性輸尿管上段結(jié)石的臨床效果。方法 選取2017年1月～2018年3月我院收治的80例嵌頓性輸尿管上段結(jié)石患者作為研究對(duì)象，并按治療術(shù)式的不同將患者分為兩組，每組各40例。對(duì)照組患者采取后腹腔鏡手術(shù)取石術(shù)進(jìn)行治療，研究組患者則采取微通道經(jīng)皮腎鏡進(jìn)行治療。比較兩組患者的手術(shù)時(shí)間、術(shù)中出血、結(jié)石取凈率、住院時(shí)間、術(shù)后疼痛視覺模擬評(píng)分（VAS）及并發(fā)癥發(fā)生情況。結(jié)果 研究組患者的手術(shù)時(shí)間、住院時(shí)間均短于對(duì)照組，術(shù)后24 h VAS評(píng)分低于對(duì)照組，差異有統(tǒng)計(jì)學(xué)意義（P<0.05），而兩組患者的術(shù)中出血量比較，差異無統(tǒng)計(jì)學(xué)意義（P>0.05）;研究組患者的結(jié)石取凈率（100.00%）高于對(duì)照組（90.00%），差異有統(tǒng)計(jì)學(xué)意義（P<0.05）;研究組患者的并發(fā)癥總發(fā)生率（5.00%）與對(duì)照組（7.50%）比較，差異無統(tǒng)計(jì)學(xué)意義（P>0.05）。結(jié)論 微通道經(jīng)皮腎鏡治療嵌頓性輸尿管上段結(jié)石的臨床效果肯定，并有操作簡(jiǎn)單、康復(fù)快等優(yōu)勢(shì)，在結(jié)石取凈率方面也有優(yōu)越性，值得借鑒。

[關(guān)鍵詞]結(jié)石取凈率;微通道經(jīng)皮腎鏡;后腹腔鏡;嵌頓性輸尿管上段結(jié)石

[中圖分類號(hào)] R693.4? ? ? ? ? [文獻(xiàn)標(biāo)識(shí)碼] A? ? ? ? ? [文章編號(hào)] 1674-4721（2019）6（a）-0086-03

[Abstract] Objective To investigate the clinical effect of microchannel percutaneous nephroscopy and retroperitoneal laparoscopy in the treatment of incarcerated upper ureteral calculi. Methods A total of 80 cases of incarcerated upper ureteral calculi admitted to our hospital from January 2017 to March 2018 were selected as research objects. The patients were divided into two groups， with 40 cases in each group. The control group was treated by retroperitoneal laparoscopic lithotomy， and the study group was treated by microchannel percutaneous nephroscopy. Operative time， intraoperative bleeding， stone removal rate， length of hospital stay， visual analogue score （VAS） for postoperative pain and complications were compared between the two groups. Results The operation time and hospitalization time of patients in the study group were shorter than those in the control group， and the VAS score of 24 h after surgery was lower than that in the control group， the differences were statistically significant （P<0.05）， while there was no significant difference in intraoperative blood loss between the two groups （P>0.05）. The stone removal rate in the study group （100.00%） was higher than that in the control group （90.00%）， and the difference was statistically significant （P<0.05）. The total incidence of complications in the study group （5.00%） was compared with that in the control group （7.50%）， and the difference was not statistically significant （P>0.05）. Conclusion Microchannel percutaneous nephrolithotomy for the treatment of incarcerated upper ureteral calculi has definite clinical effect， and has the advantages of simple operation， quick recovery and so on. It also has advantages in stone removal rate and is worth learning.

[Key words] Stone clearance rate; Microchannel percutaneous nephroscopy; Retroperitoneal laparoscopy; Incarcerated upper ureteral calculi