本文選題：輸尿管鏡碎石取石術(shù) + 封堵器�。� 參考：《實用醫(yī)學雜志》2017年13期

【摘要】：目的比較輸尿管鏡聯(lián)合封堵器與斜臥截石聯(lián)合體位微創(chuàng)經(jīng)皮腎鏡治療輸尿管上段嵌頓性結(jié)石的臨床治療效果。方法回顧性分析2014年1月至2016年12月在我院住院行手術(shù)治療的97例輸尿管上段嵌頓性結(jié)石患者。隨機分成兩組:輸尿管鏡聯(lián)合封堵器組,52例;微創(chuàng)經(jīng)皮腎鏡組,45例。兩組間性別、年齡、結(jié)石大小無明顯差異。結(jié)果微創(chuàng)經(jīng)皮腎鏡組和輸尿管鏡聯(lián)合封堵器組的術(shù)中、術(shù)后各項指標分別為:手術(shù)時間(78.2±14.1)min vs.(53.3±12.4)min(P0.05),手術(shù)成功率為97.8%vs.94.2%(P0.05),結(jié)石清除率為100%vs.91.8%(P0.05),并發(fā)癥發(fā)生率為4.4%vs.3.9%(P0.05),住院時間(9.1±3.2)d vs.(5.5±1.4)d(P0.05)。所有患者均未出現(xiàn)感染性休克,無輸尿管損傷、腸道損傷等并發(fā)癥。結(jié)論輸尿管鏡聯(lián)合封堵器和斜臥截石聯(lián)合體位微創(chuàng)經(jīng)皮腎鏡均是治療輸尿管上段嵌頓性結(jié)石的安全、有效的手術(shù)方式。具體術(shù)式的選擇須根據(jù)患者的病情特點和醫(yī)生的手術(shù)經(jīng)驗等因素綜合考慮。
[Abstract]:Objective to compare the clinical effect of ureteroscopy combined with occluder and oblique recumbent lithotomy combined with minimally invasive percutaneous nephroscopy in the treatment of upper ureteral incarcerated calculi. Methods 97 patients with upper ureteral incarcerated calculi who were hospitalized in our hospital from January 2014 to December 2016 were analyzed retrospectively. They were randomly divided into two groups: ureteroscope combined with occluder group (n = 52) and minimally invasive percutaneous nephroscopy group (n = 45). There was no significant difference in sex, age and stone size between the two groups. Results in the minimally invasive percutaneous nephroscope group and ureteroscopy combined occluder group, the operative time was 78.2 鹵14.1)min vs.(53.3 鹵12.4min P0.05, the success rate was 97.8vs.94.2p0.05, the stone clearance rate was 100vs.91.8crest, the complication rate was 4.4vs.3.9m P0.05a, and the hospitalization time was 9.1 鹵3.2d vs.(5.5 鹵1.4dP0.05. No septic shock, no ureteral injury or intestinal injury were found in all patients. Conclusion the combination of ureteroscopic occluder and oblique recumbent lithotomy combined with minimally invasive percutaneous nephroscopy is a safe and effective method for the treatment of upper ureteral incarcerated calculi. The choice of operation method should be considered according to the patient's condition and the doctor's operation experience.
【作者單位】： 廣東省梅州市人民醫(yī)院泌尿外一科;廣東省梅州市人民醫(yī)院外四科;廣州醫(yī)科大學附屬第五醫(yī)院泌尿外科;
【基金】：基金項目:廣東省梅州市醫(yī)藥衛(wèi)生立項(編號:2015-B-3)
【分類號】：R699.4

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