输尿管软镜和微通道经皮肾镜碎石取石术治疗 肥胖患者输尿管上段结石的对比分析

Comparative analysis of the retrograde flexible reteroscopic lithotripsy and mini-pereutaneous nephrolithotomy in obese patients with upper-ureter calculi

摘要:

目的 对比分析输尿管软镜及微通道经皮肾镜取石术（Mini-PCNL）治疗肥胖患者输尿管上段结石的疗效及安全性。方法 收集2010年5月至2013年7月入住该科的82例患输尿管上段结石的肥胖患者的临床资料，根据治疗方法的不同分为输尿管软镜组和Mini-PCNL组，其中输尿管软镜组39例，Mini-PCNL组43例。分析两种方法的手术时间、碎石成功率、术后住院天数和并发症。结果 输尿管软镜组和Mini-PCNL组的手术时间分别为（85.9±16.8）和（81.5±18.8）min（P >0.05），一期结石清除率分别为92.3%和74.4%（P <0.05），术后住院天数分别为（5.4±1.4）和（6.5±1.3）d（P <0.05），并发症发生率分别为10.3%和34.9%（P <0.05）。结论 输尿管软镜较微通道经皮肾镜治疗肥胖患者输尿管上段结石成功率和安全性较高，并发症发生率较低，可作为一种较理想的治疗方法。

Abstract:

【Objective】 To analyze the efficacy and tolerability of retrograde flexible reteroscopic lithotripsy and mini-pereutaneous nephrolithotomy (Mini-PCNL) in obese patients with upper-ureter calculi. 【Methods】 From May 2010 to July 2013, 82 cases of obese patients merger the upper-ureter calculi we prospectively collected and divided into two groups (group of Flexible Ureteroscopic: 39 cases, group of Mini-PCNL: 43 cases). The success rate of stone fragmentation, the mean operating time, hospitalization days and complication rate of patients undergoing flexible ureteroscopic lithotripsy or Mini-PCNL were recorded. 【Results】 The operating time of flexible ureteroscopic lithotripsy and Mini-PCNL were (85.9±16.8) min and (81.5±18.8) min respectively (P >0.05), initial stone-free rate were 92.3% and 74.4% respectively (P <0.05), postoperative hospital stay were (5.4±1.4) days and (6.5±1.3) days respectively (P <0.05), side effects rates were 10.3% and 34.9% respectively (P <0.05). 【Conclusion】 Retrograde flexible ureteroscopic lithotripsy treat with the obese patients with upper-ureter calculi appeared to be effective, safe and fewer complications, can be used as an ideal treatment.