中下段输尿管结石气压弹道碎石与ESWL的比较

目的探讨输尿管中下段结石的首选方法和适应证.方法对260例输尿管中下段结石患者行TUPL和ESWL治疗,其中男150例,女110例.年龄16～74岁,平均40.2岁,中段结石80例,下段结石180例,结石最小4mm×5mm,最大12mm×25mm.结果TUPL组1次碎石成功率为96.3%,术中结石取净率93%,3个月后结石排空率达98.6%.ESWL组1次粉碎率96%,粉碎排空率74%,3个月后结石排空率为85%.结论在设备技术条件具备的医院,对输尿管中下段结石可首选TUPL.

A Comparison of Pneumatic Lithotripsy and Extracorporeal Shock Wave Lithotripsy in the Treatment of Middle and Lower Ureteral Calculi

Objective:To determine the first line treatment and indication for middle and lower ureteral stones.Methods:260 patients (male=150,female=110) with middle and lower ureteral stones were treated with transurethral ureteroscopy pneumatic lithotripsy(TUPL) and extracorporeal shockwave lithotirpsy (ESWL).The patients of middle and lower ureteral stones were 80 and 180,respectively.Results:Success rate after initial treatmnet was 96.3%,stone-free rate was 93% in operation and stone-free was 98.6% after follwing up of 3 monthes in group of TUPL.The rate of fragment was 96% in the first ESWL,stone-free rate was 74% in post-ESWL and 85% after 3 monthes of ESWL.All successes were confirmed by plain abdominal X-rays postoperatively.Conclusions:We recommend TUPL as the first line treatment for middle and lower ureteral stones,when the hospitals have the suitable equipments and skills.