头高脚低截石体位输尿管镜联合封堵器与微创经皮肾镜治疗输尿管上段嵌顿性结石的效果对比

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Abstract Objective To compare the safety and effectiveness of ureteroscopy in reverse Trendelenburg stone lithotomy position combined with occluder and minimally invasive percutaneous nephrolithotomy in the treatment of upper ureteral incarcerated calculi.Methods Eighty five patients who underwent minimally invasive surgeries for upper ureteral incarcerated calculi （with stone position above the lumbar vertebra 4）in our hospital from January 1，2017 to December 31，2018 were selected as research objects.According to different treatment methods，they were divided into observation group （n=44）and control group （n=41）.The ureteroscope combined with occluder was used in the observation group，and holmium laser lithotripsy was given.In the control group，the minimally invasive percutaneous nephroscope was given，and the pneumatic ballistic lithotripsy was adopted.The success rate of the lithotripsy，stone clearance rate，operation time，hospitalization time，hospitalization cost and complications were compared between the two groups.Results The success rate of lithotripsy in the observation group was 95.4%，and the stone clearance rate was 95.2%，which were not significantly different from those in the control group respectively accounting for 100.0%and 97.6%（P＞0.05）.The operation time and hospitalization time in the observation group were shorter than those in the control group，the hospitalization cost and the total incidence of complications were lower than those in the control group，and the differences were statistically significant （P＜0.05）.Conclusion The ureteroscopy in reverse Trendelenburg stone lithotomy position combined with occluder and minimally invasive percutaneous nephrolithotomy are both effective methods for the treatment of incarcerated calculi in the upper ureter.The incidence rate of postoperative complications was lower and safety was higher in the ureteroscopy in reverse Trendelenburg stone lithotomy position combined with occlude，which is a better choice for the treatment of incarcerated calculi in the upper ureter.

Key words： Occluder Reverse Trendelenburg stone lithotomy position Ureteroscopic lithotripsy Minimally invasive percutaneous nephroscope

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