逆行与顺行输尿管镜术处理输尿管上段嵌顿性结石的疗效比较.doc

1 逆行与顺行输尿管镜术处理输尿管上段嵌顿性结石的疗效比较作者:王炜王谷丰蒋国华温洪波甄旭彦【摘要】目的比较逆行与顺行输尿管镜术处理输尿管上段嵌顿性结石的疗效,并对其安全性与有效性进行评价。方法采用输尿管镜术共治疗输尿管上段嵌顿性结石 246 例, 其中逆行经尿道入路治疗 186 例, 顺行经皮肾微造瘘入路 60 例。结果逆行经尿道入路手术成功 173 例(93%) ,平均手术时间 35min ,平均住院时间 5d ,无石率 % ,22例需 ESW L 辅助治疗, 出现手术并发症9例(%) ; 顺行经皮肾微造瘘入路手术成功 60例(100%) ,平均手术时间 55min ,平均住院时间 8d ,无石率 100% ,无手术并发症发生。结论逆行与顺行输尿管镜术处理输尿管上段嵌顿性结石均有较高的手术成功率与术后无石率; 顺行入路的安全性与有效性更好,但手术时间及住院时间更长。【关键词】输尿管结石输尿管镜术逆行经尿道入路顺行经皮肾微造瘘 parison of the es of retrograde and antegrade access ureterolithotripsy for impacted upper ureteric calculi ABSTRACT: Objective pare the es of retrograde and antegrade access ureterolithotripsy for impacted upper ureteric calculi and to assess the safety and efficiency of the two types of minimally invasive technique. Methods A total of 246 patients with impacted upper ureteric calculi were treated with ureterolithotripsy. The procedure was performed via retrograde transurethral access in 186 patients and via antegrade percutaneous nephrostomy tract in 60 patients. Results The ess rate of retrograde approach was 93%. Mean operating time was 35 min with mean hospital stay of5 days. The stone free rate was % at1 month follow 拟 up. 22 patients(%) with residual calculi required bination. Complications were noted in %. The ess rate of antegrade approach was 100%. Mean operating time was 55 min with mean hospital stay of8 days. The stone free rate was 1