杨庭广

[摘要]目的 探讨经腹腹腔镜治疗输尿管上段结石的临床效果。方法 选取2016年1～10月我院收治的120例经检查确诊为输尿管上段结石的患者作为研究对象，按照随机数字表法分为观察组与对照组，各60例。对照组采用输尿管镜钦激光碎石法，观察组采用腹腔镜辅助切开输尿管取石方法，比较两组的手术恢复情况、并发症发生情况以及结石清除情况。结果 观察组的卧床时间、手术所耗时长及住院时间长于对照组，出血量多于对照组，差异有统计学意义（P<0.05）。观察组的并发症总发生率为5.00%，显著低于对照组的16.67%，差异有统计学意义（P<0.05）。观察组的结石清除率为100%，高于对照组的95%，差异有统计学意义（P<0.05）。结论 将腹腔镜辅助切开输尿管取石法应用于输尿管上段结石患者的临床治疗中，可有效清除患者的结石，降低并发症发生率，但是该方法在手术过程中具有耗时长、出血量多的劣势。

[关键词]经腹腹腔镜；输尿管；上段结石

[中图分类号] R693+.4 [文献标识码] A [文章编号] 1674-4721（2017）04（c）-0044-03

[Abstract]Objective To investigate the clinical effect of transabdominal laparoscope in the treatment of upper ureteral calculi.Methods 120 patients who diagnosed as upper ureteral calculi in our hospital from January to October 2016 were selected and divided into the observation group and the control group according to random number table methods，and each group was 60 cases.The control group was used ureteroscopic laser lithotripsy，and the observation group was used laparoscopic assisted ureterolithotomy.The operative recovery，complications and stone removal were compared between the two groups.Results The bed stay time，the operation time，and hospital stay in the observation group was longer than that in the control group，bleeding volume in the observation group was more than that in the control group，with significant difference （P<0.05）.The incidence rate of complications in the observation group was 5.00%，which was significantly lower than that of the control group （16.67%），with significant difference （P<0.05）.The stone clearance rate of the observation group was 100%，which was higher than that of the control group （95%），with significant difference （P<0.05）.Conclusion Using laparoscopic assisted ureterolithotomy in the treatment of upper ureteral calculi can effectively remove the patients′ stone and reduce the incidence rate of complications.However，this method has the disadvantages of long time and large amount of bleeding in the operation.

[Key words]Transabdominal laparoscope；Ureter；Upper stone

近年來，泌尿系统疾病的发生率呈现逐年升高趋势，输尿管上段结石是泌尿系统常见病之一。所谓的上段结石，是指发生在输尿管以及肾部位的结石[1-3]。在临床中，男性患者的发病率约为女性的3倍，且常发生于中年人群中。该病的主要临床症状有血尿、尿痛等，劳动量的增加也会导致患者病情加重，若不及时治疗，则会导致患者出现梗阻、肾积水以及上腹部或腰部肿块[4-7]。目前，腹腔镜辅助切开输尿管取石法在临床治疗中取得了较好的临床治疗效果。基于此，我院就此方法展开探究，取得了较好的效果，现报道如下。

1资料与方法

1.1一般资料

选取2016年1～10月我院收治的120例经检查确诊为输尿管上段结石的患者，按照随机数字表法分成观察组与对照组，各60例。对照组中，男15例，女45例；年龄（39.3±1.2）岁；患病时间为（3.1±1.4）年。观察组中，男16例，女44例；年龄（40.1±1.1）岁；……