目的探讨不同手术方式治疗输尿管结石的效果。方法方便选取2017年3月—2018年6月贵阳医学院第二附属医院收治的90例输尿管结石患者,随机分为研究组和对照组。对照组采用腹腔镜下输尿管切开取石术治疗。研究组采用输尿管镜下钬激光碎石术治疗。记录两组的手术时间、手术失血、总住院天数。记录两组的首次碎石成功、二次手术、结石清除情况。对比两组的并发症发生率。结果研究组的手术时间(38.15±5.49)min vs (52.08±6.72)min、手术失血(13.25±3.14)mL vs (41.09±6.53)mL、总住院天数(3.74±0.85)d vs (6.95±1.34)d低于对照组,差异有统计学意义(t=10.769、25.775、13.570,P<0.05);研究组的首次碎石成功(77.78% vs 93.33%)、结石清除(20.00% vs 2.22%)低于对照组,但二次手术率(82.22% vs 97.78%)比对照组高,差异有统计学意义(P<0.05);研究组的并发症发生率低于对照组(11.11% vs 26.67%),差异有统计学意义(P<0.05)。结论腹腔镜下输尿管切开取石术具有结石清除率高、并发症高的特点,输尿管镜下钬激光碎石术具有手术时间短、出血量低、恢复快、并发症少等特点,但结石清除率较低,需进行二次手术率较高。
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.
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