本文選題：后腹腔鏡腎盂輸尿管切開取石術(shù) + 腎盂結(jié)石�。� 參考：《福建醫(yī)科大學(xué)》2014年碩士論文

【摘要】：目的：探討腹膜后腹腔鏡與開放手術(shù)治療腎盂輸尿管結(jié)石的療效及臨床應(yīng)用價值。 方法：回顧性分析福建醫(yī)科大學(xué)附屬協(xié)和醫(yī)院2010年1月～2013年12月期間171例上尿路結(jié)石手術(shù)病例資料，其中101例采用腹膜后腹腔鏡腎盂輸尿管切開取石術(shù)，70例采用開放手術(shù)治療。對比兩者間的手術(shù)時間、術(shù)中出血、肛門排氣時間、術(shù)后進食時間、下床活動時間、引流管留置時間、術(shù)后并發(fā)癥、結(jié)石殘留率、術(shù)后鎮(zhèn)痛藥使用次數(shù)、術(shù)后住院時間及住院費用等。 結(jié)果：所有手術(shù)均獲得成功,兩例后腹腔鏡手術(shù)分別因腎周粘連嚴重及術(shù)中動脈性出血改開放手術(shù)治療，歸為開放組。后腹腔鏡組與開放組相比，在術(shù)中出血（42.43±28.17ml vs151.51±266.25ml）、肛門排氣時間（1.15±0.36d vs2.29±0.92d）、術(shù)后進食時間（1.73±0.66d vs2.44±0.91d）、下床活動時間（2.25±1.23d vs2.08±0.93d）、結(jié)石殘留率[1(0.99%) vs8(11.43%)]、并發(fā)癥發(fā)生率[15(14.85%) vs21(30.00%)]、術(shù)后住院時間（6.73±2.65d vs9.70±6.91d）、總住院費用（21991.77±6696.36元vs24764.76±9655.87元）等方面明顯優(yōu)于開放組(均P0.05)。而在手術(shù)時間(137.4±50.13min vs162.86±109.4min)、引流管留置時間（5.03±2.80d vs5.63±2.17d）、鎮(zhèn)痛藥使用次數(shù)方面（6.67±6.07vs7.05±7.49），兩者沒有明顯的統(tǒng)計學(xué)差別（均P0.05）。 結(jié)論：后腹腔鏡腎盂輸尿管切開取石術(shù)作為治療腎盂輸尿管結(jié)石一種微創(chuàng)手術(shù)方式，其具有損傷小、出血少、恢復(fù)快、并發(fā)癥少等優(yōu)點，現(xiàn)在技術(shù)較為成熟，可部分取代傳統(tǒng)的開放手術(shù)，，但在實際應(yīng)用中應(yīng)根據(jù)患者病情、經(jīng)濟條件以及術(shù)者技術(shù)水平等因素綜合考慮，合理選擇手術(shù)方式。
[Abstract]:Objective: to evaluate the efficacy and clinical value of retroperitoneal laparoscopy and open surgery in the treatment of ureteropelvic calculi.Methods: the data of 171 cases of upper urinary calculi from January 2010 to December 2013 in Union Hospital of Fujian Medical University were analyzed retrospectively. Among them, 101 cases were treated by retroperitoneal laparoscopic ureterolithotomy and 70 cases were treated by open surgery.The operative time, intraoperative bleeding, anus exhaust time, postoperative feeding time, the time of getting out of bed, the time of drainage tube indwelling, postoperative complications, the residual rate of stone, the number of times of using analgesics after operation, and the time of analgesics after operation were compared.Postoperative hospital stay and hospitalization expenses.Results: all the operations were successful. Two cases of retroperitoneal laparoscopic surgery were classified as open group due to severe perirenal adhesions and intraoperative arterial hemorrhage.The retroperitoneal laparoscopic group compared with the open group,鍦ㄦ湳涓嚭琛

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