【摘要】 目的:探讨后腹腔镜输尿管切开取石术(retroprritoneal laparoscopic ureterolithotomy,RLU)对输尿管上段复杂性结石患者术后并发症、围手术期疼痛以及结石清除率的影响,以期为临床提供参考。方法:选择2016年3月-2020年6月在本院治疗的72例输尿管上段复杂性结石患者为研究对象。按照随机分组的方式将患者分为RLU组和微创经皮肾镜碎石术(MPCNL)组,每组36例。RLU组采用RLU,MPCNL组采用MPCNL。比较两组患者围术期情况、结石清除效果、围手术期疼痛情况以及术后并发症发生情况。结果:两组手术时间比较,差异无统计学意义(P>0.05);RLU组术中出血量少于MPCNL组,尿管拔除时间、住院时间均短于MPCNL组,一次性结石清除率高于MPCNL组,差异均有统计学意义(P<0.05)。术后24 h,RLU组5-HT水平和NRS评分均低于MPCNL组,差异均有统计学意义(P<0.05)。RLU组的术后并发症发生率为8.33%,与MPCNL组的13.89%比较,差异无统计学意义(P>0.05)。结论:相对于MPCNL术式来说,RLU术式治疗输尿管上段复杂性结石患者具有一次性结石清除率高、术中出血量少、恢复快的优点,且不增加术后并发症发生率,临床上值得推广。更多还原

【Abstract】 Objective:To explore the effects of retroprritoneal laparoscopic ureterolithotomy (RLU) on postoperative complications,perioperative pain and stone clearance rate in patients with complicated upper ureteral calculi,and to provide a clinical reference.Method:A total of 72 patients with complicated upper ureteral calculi treated in our hospital from March 2016 to June 2020 were selected as the research subjects.Patients were randomly divided into RLU group and minimally invasive percutaneous nephrolithotripsy (MPCNL) group,36 cases in each group.RLU group was treated with RLU,and MPCNL group was treated with MPCNL.The perioperative conditions,stone removal effect,perioperative pain and postoperative complications were compared between the two groups.Result:There was no significant difference between the two groups in the operation time (P>0.05).The bleeding volume in RLU group was less than that of MPCNL group,the time of catheter removal and hospitalization were shorter than those of MPCNL group,and the one-time stone removal rate was higher than that of MPCNL group,the differences were statistically significant (P<0.05).24 h after operation,the 5-HT level and NRS score of RLU group were lower than those of MPCNL group,the differences were statistically significant (P<0.05).The incidence of postoperative complications in the RLU group was 8.33%,compared with 13.89% in the MPCNL group,there was no statistical significance (P>0.05).Conclusion:Compared with MPCNL,RLU in the treatment of patients with complicated upper ureteral calculi has the advantages of high one-time stone clearance rate,less intraoperative blood loss and fast recovery,and does not increase the incidence of postoperative complications,which is worthy of promotion in clinical practice.更多还原