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| Analysis of the Curative Effect of Laparoscopic Transrenal and Ureteroscopy in the Treatment of Upper Ureteral Stones of Incarcerated Ureter |
| ZHANG Dongbang, et al |
| Qinghai Red Cross Hospital, Qinghai Xining 810000, China |
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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.
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[1] 吕远,许长宝,马静,等.“一步法”输尿管软镜治疗嵌顿性输尿管上段结石的临床分析[J].中华泌尿外科杂志,2017,38(5):371~374.
[2] 鲁成军,王亦农,田金波,等.三种微创碎石术治疗复杂性输尿管上段结石的临床对比研究[J].腹腔镜外科杂志,2017,22(7):501~504.
[3] 蒲小勇,刘久敏,毕学成,等.腹腔镜肾盂切开取石术与经皮肾镜碎石取石术在大于2.5cm肾盂结石处理中的临床效果比较[J].南方医科大学学报,2017,37(2):251~255.
[4] 赵树田,屈平保,钱海宁,等.微创经皮肾镜碎石术联合输尿管软镜治疗青年嵌顿性输尿管上段结石效果观察[J].山东医药,2016,56(10):80~81.
[5] 吴跃,付炼,胡华,等.后腹腔镜输尿管切开取石术治疗嵌顿性输尿管上段结石体会(附4例报告)[J].检验医学与临床,2016,13(16):2406~2407.
[6] 阳旭明,马子芳,资小龙,等.标准通道辅助微通道经皮肾镜取石术联合EMS治疗鹿角形肾结石合并脓肾的经验总结[J].中国内镜杂志,2017,23(12):106~110 |
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2019, Vol. 25 
