李国庆　赵宏伟　王　林

平煤神马医疗集团总医院泌尿外科，河南平顶山467000

经皮肾镜取石术与输尿管镜碎石术治疗嵌顿性输尿管上段结石疗效对比

李国庆赵宏伟王林

平煤神马医疗集团总医院泌尿外科，河南平顶山467000

目的对比分析经皮肾镜取石术与输尿管镜碎石术治疗嵌顿性输尿管上段结石的临床疗效。方法收集我院2012年6月～2015年6月期间诊治的56例嵌顿性输尿管上段结石患者，将其随机为研究组（28例）与对照组（28例），其中，对照组采用输尿管镜碎石术，研究组患者采用经皮肾镜取石术取石，观察两组患者的取石成功率和并发症发生率、手术时间、血红蛋白下降程度、住院时间。结果研究组取石成功率为96.43%，对照组取石成功率为78.57%，研究组取石成功率明显高于对照组（P＜0.05），且研究组并发症发生率为3.57%，对照组并发症发生率为21.43%，研究组并发症发生率明显低于对照组（P＜0.05）；同时，研究组患者的手术时间明显短于对照组（P＜0.05），血红蛋白下降程度明显大于对照组（P＜0.05），住院时间明显短于对照组（P＜0.05）。结论与输尿管镜碎石比较，采用经皮肾镜取石术治疗嵌顿性输尿管上段结石能够显著提高取石成功率，减少并发症发生，并促进患者的血红蛋白改善，缩短患者的手术时间、住院时间。

经皮肾镜取石术；嵌顿性输尿管上段结石；输尿管镜碎石术；并发症；血红蛋白

［Abstract］Objective To compare and analyze the clinical effects of percutaneous nephrolithotomy and ureteroscopic lithotripsy in the treatment of incarcerate upper ureteric calculus.Methods A total of 56 patients with incarcerate upper ureteric calculus who were diagnosed and treated in our hospital from June 2012 to June 2015 were collected，and they were randomly assigned to the research group（28 patients）and control group（28 patients）.Among them，the calculus removal approach in the control group was ureteroscopic lithotripsy，and the calculus removal approach in the research group was percutaneous nephrolithotomy.Calculus removal successful rate，incidence rate of complications，surgery time，decreasing degree of hemoglobin，and length of stay were observed in the two groups.Results The successful rate of calculus removal was 96.43%in the research group，and 78.57%in the control group.The successful rate of calculus removal in the research group was significantly higher than that in the control group（P＜0.05）.The incidence rate of complications was 3.57%in the research group and 21.43%in the control group，the incidence rate of complications in the research group was significantly lower than that in the control group（P＜0.05）；meanwhile，the surgery time in the research group was significantly shorter than that in the control group（P＜0.05），the decreasing degree of hemoglobin was significantly higher than that in the control group（P＜0.05），and the length of stay was significantly shorter than that in the control group（P＜0.05）.Conclusion Compared with ureteroscopic lithotripsy，percutaneous nephrolithotomy in the treatment of incarcerate upper ureteric calculus is able to significantly improve the successful rate of calculus removal，reduce complications，promote the improvement of patients'hemoglobin，and shorten patients' surgery time and length of stay.

［Key words］Percutaneous nephrolithotomy；Incarcerate upper ureteric calculus；Ureteroscopic lithotripsy；Complications；Hemoglobin

输尿管上段结石在所有泌尿外科结石中属于发生率较高的类型，患者在病情确诊后应及时通过手术治疗，近年来临床上逐步推广了体外冲击碎石，有效避免了传统手术的缺陷，显著提高了治疗效果。……