钬激光与气压弹道碎石治疗上段输尿管结石1085例比较研究

目的探讨输尿管镜下钬激光与气压弹道碎石治疗上段输尿管结石的疗效差异.方法回顾性分析2004年6月至2009年6月输尿管镜下钬激光与气压弹道碎石治疗1085例上段输尿管结石的临床资料.结果一次性碎石成功率钬激光组为92.3%（491/532）、气压弹道组为85.2%（471/553）,两组一次性碎石成功率差异有统计学意义（P〈0.05）;钬激光组手术时间显著短于气压弹道组（P〈0.05）;住院时间两组比较差异有统计学意义（P〉0.05）;术后3周复查KUB平片,结石排净率钬激光组为98.98%（486/491）、气压弹道组为91.08%（429/471）,两组结石排净率差异有统计学意义（P〈0.05）.结论钬激光治疗上段输尿管结石一次性碎石成功率及结石排净率高于气压弹道碎石,手术时间短于气压弹道碎石.

Comparison of Holmium Laser and Pneumatic Lithotripsy in the Treatment of Upper-Ureteral Calculi: Report of 1085 Cases

Objective To compare the efficacy of Holmium：YAG laser and pneumatic lithotripsy in the treatment of upper-ureteral calculi.Methods We retrospectively analyzed the clinical data of 1085 patients with upper-ureteral calculi who underwent ureteroscopic lithotripsy with Holmium：YAG laser or pneumatic lithotripter at our department from June 2004 to June 2009.Results The one-time success rate of lithotripsy was 92.3%（491/532） in the patients received holmium laser,and 85.2%（471/553） in those who underwent pneu-matic lithotripter.There was significant difference in the one-time success rate of lithotripsy between the two groups（P0.05） .The operation time was significantly shorter in holmium laser group than that in pneumatic lithotripter group（P0.05） .There was no significant difference in hospital stay time between two groups（P 0.05） .Patients were reviewed by KUB plain 3 weeks after lithotripsy.The stone-free rate was 98.98%（486/491） in the Holmium laser group,which was significantly higher than that in the pneumatic lithotripter group 91.08%（429/471） （P0.05） . Conclusions The one-time success rate of lithotripsy and stone-free rate in holmium laser group is higher than that in pneumatic lithotripter group.The operation time is shorter in holmium laser group than that in pneumatic lithotripter group.