【摘要】 目的比较输尿管镜碎石(URL)、微创经皮肾镜取石(MPCNL)、后腹腔镜下输尿管切开取石(RLU)治疗复杂性输尿管上段结石的疗效。方法回顾分析2002年2月至2010年2月复杂性输尿管上段结石212例,其中URL治疗52例,MPC-NL治疗107例,RLU治疗54例。比较分析3种手术的治疗效果。结果术后7 d结石清除率:URL组36.5%(19/52),MPCNL组75.7%(81/107),RLU组90.6%(48/53)。术后1个月结石清除率:URL组73.1%(38/52),MPCNL组95.3%(102/107),RLU组96.2%(51/53)。术后3个月结石清除率:URL组82.7%(43/52),MPCNL组98.1%(105/107),RLU组98.1%(52/53)。URL组分别与MPCNL组、RLU组比较差异有统计学意义(P<0.05),MPCNL、RLU组之间比较近期差异有统计学意义(P<0.05),远期无显著性差异。结论复杂性输尿管上段结石治疗RLU,MPCNL均有很高的结石清除率,URL效果较差。更多还原

【Abstract】 Objective To compare the efficacy of three procedures,ureteroscopic litripsy(URL),minimally invasive percutaneous nephrolithotomy(MPCNL),and retroperitoneal laparoscopic ureterolithomy(RLU),for the treatment of complicated upper ureteral calculi.Methods Two hundred and thirteen cases of complicated upper ureteral calculi were treated in this hospita1 from February 2002 to February 2010,including fifty-two cases of URL,one hundred and seven cases of MPCNL,and fifty-four cases of RLU.Results The stone-free rate seven days after operation:URL was 36.5%(19/52),MPCNL was 75.7%(81/107),RLU was 90.6%(48/53);the stone-free rate one months after operation:URL was 71.1%(38/52),MPCNL was 95.3%(102/107),RLU was 96.2%(51/53);the stone-free rate three months after operation:URL was 82.7%(43/52),MPCNL was 98.1%(105/107),RLU was 98.1%(52/53).There was significantly difference between URL and MPCNL(P<0.05),URL and RLU(P<0.05).There was also significantly difference between MPCNL and RLU in the near future(P<0.05),but had no difference in long term.Conclusion High stone-free rate can be obtained with RLU and MPCNL for impacted upper ureteral calculi.The stone-free rate is less satisfactory with URL.更多还原