Abstract：Objective: To analyze and discuss the difference of curative effect of three methods of treatment (laparoscopic (RLU), transnephroscopic (mPCNL) and transureteroscopic (URL) adjuvant therapies) for patients with incarcerated upper ureteral calculi. Methods: 87 patients with incarcerated upper ureteral calculi admitted to our hospital from January 2012 to May 2018 were randomly divided into RLU group of 29 cases (using RLU surgical lithotripsy), mPCNL group of 29 cases (using mPCNL surgical lithotripsy) and URL group of 29 cases (using URL surgical lithotripsy). The operation time, intraoperative bleeding volume and post-operative pain score of the three groups were compared, and the complications of the three groups were recorded. Results: There were significant differences in blood loss, operation time, primary stone clearance rate, postoperative pain score, postoperative activity recovery time and hospitalization cost among the three groups (P < 0.01).The amount of intraoperative bleeding in RLU group was (187.8 ±45.9) ml. The operative time was (89.14 ±21.50) min,The postoperative pain score was (3.80 ±1.30), the recovery time of postoperative activity was (4.6 ±1.4) days, the hospitalization cost was (10.72 ±2.87) thousand yuan, and the intraoperative bleeding volume in mPCNL group was (225.5 ±42.0) ml,. The operative time was (87.31 ±19.62) min,The postoperative pain score was (4.25 ±1.60), the recovery time of postoperative activity was (2.3 ±1.2) days, the cost of hospitalization was (10.56 ±2.38) thousand yuan, the clearance rate of one stone was 96.55, the score of postoperative pain was (4.25 ±1.60), the recovery time of postoperative activity was (2.3 ±1.2) days.the hospitalization cost was (10.56 ±2.38) thousand yuan, which was significantly higher than that in the URL group [(162.6 ±38.1) ml, (42.68 ±14.36) min,82.76%, (3.20 ±1.15), (1.6 ±0.8) d, (4.21 ±1.23) thousand yuan].the difference was statistically significant (P < 0.05 ~0.01). The amount of intraoperative bleeding in mPCNL group was significantly higher than that in RLU group, but the recovery time of postoperative activity in mPCNL group was significantly shorter than that in RLU group (P<0. 01). Conclusions: RLU, mPCNL and URL can be used in the treatment of incarcerated upper ureteral calculi. Among them, RLU and mPCNL have higher stone clearance rate. Although compared with RLU, mPCNL has faster recovery time after operation and can be the first choice for the treatment of such calculi, it has a certain risk of bleeding.
张栋邦, 杨姗. 腹腔镜经肾镜经输尿管镜辅助治疗嵌顿性输尿管上段结石的疗效差异性分析[J]. 河北医学, 2019, 25(6): 935-938.
ZHANG Dongbang, et al. Analysis of the Curative Effect of Laparoscopic Transrenal and Ureteroscopy in the Treatment of Upper Ureteral Stones of Incarcerated Ureter. HeBei Med, 2019, 25(6): 935-938.
2019, Vol. 25 
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