作　　者： (）;

机构地区： 广东医科大学附属医院

出　　处： 《临床泌尿外科杂志》 2017年第1期61-64,共4页

摘　　要： 目的:通过对输尿管软镜钬激光碎石术(fURL)与经皮肾镜取石术(PCNL)治疗输尿管上段大结石疗效的比较,探讨fURL治疗输尿管上段大结石的有效性及安全性。方法:回顾性分析2014年2月~2015年8月随机采用fURL(fURL组)与PCNL(PCNL组)治疗的85例输尿管上段大结石患者的临床资料,对两组患者的一般资料及手术时间、结石清除率、术后发热、血红蛋白降低值、术后住院时间、住院费用等进行比较分析。结果:两组患者一般资料差异无统计学意义(P>0.05),两组间比较具有可比性。两组85例均顺利完成手术,碎石成功,术中无严重并发症。两组手术时间差异无统计学意义[(42±16)min vs.(47±22)min]。术后PCNL组结石清除率达100%,而fURL组为97%,其中1例结石回流至肾脏下盏,3个月后仍有部分碎石未排出。术后fURL组出现1例发热。术后PCNL组血红蛋白降低值较fURL组明显高[(1.6±0.4)g/L vs.(0.5±0.2)g/L],且PCNL组较fURL组需要更长的术后住院时间及更多的住院费用。结论:fURL治疗输尿管上段结石可达到PCNL相同的治疗效果,且手术出血、住院时间及费用更少,是治疗输尿管上段结石的一种理想选择。 Objective：By means of comparing the results between flexible ureteroscopic lithotripsy with holmium laser（fURL）and percutaneous nephrolithotomy（PCNL）for treating proximal ureteral large stones,to investigate the clinical efficacy and safety of fURL.Method：From February 2014 to August 2015,85 patients with proximal ureteral large stones in my hospital were randomized to receive fURL（37cases）or PCNL（48cases）.The results of operative time,stone free rate,fever after surgery,Hb drop,hospital stay and hospital cost were compared between two groups.Result：There were no serious complications in both groups.Operative time of fURL and PCNL groups were similar[（42±16）min vs.（47±22）min].It was 100% of stone free rate in PCNL group and 97%in fURL group,but it showed no statistical difference.One patient of fURL group experienced fever after surgery.Hb drop was significantly higher in PCNL group than that in fURL group.On the other hand,fURL provided a shorter hospital stay and less hospital cost than PCNL.Conclusion：A good choice for the treatment of proximal ureteral large stones is fURL,for it can provide similar operative time and stone free rate,but less Hb drop,shorter hospital stay and less hospital cost than PCNL.

关 键 词： 输尿管结石 输尿管软镜钬激光碎石术 经皮肾镜取石术

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