超声定位体外冲击波碎石术与输尿管镜气压弹道碎石术治疗输尿管结石疗效比较

目的 比较超声引导体外冲击波碎石术（ESWL）及输尿管镜气压弹道碎石术（UPL）治疗输尿管结石的临床效果及并发症.方法 选择输尿管结石患者共80例,根据治疗方法的不同分为ESWL组和URL组,比较两种方法治疗输尿管结石有效率及并发症发生率.结果 组内比较,ESWL组上段结石碎石成功率（92.3％）明显高于中下段结石（55.6％）（x2=0.049,P＜0.05）.组间比较,UPL组中下段碎石率为96.0％,总碎石成功率为87.5,ESWL组分别是55.6％和75.0％,UPL组均明显高于ESWL组（x2 =0.001、0.032,均P＜0.05）,但两组上段结石成功率差异无统计学意义（P＞0.05）.ESWL组血尿发生率（82.5％）明显低于UPL组血尿（97.5％）（x2=0.034,P＜0.05）,但ESWL组发热、肾区疼痛及恶心呕吐发生率分别是17.5％,42.5％,37.5％,均明显高于UPL组（x2=0.023、0.033、0.004,均P＜0.05）.结论 与ESWL比较,UPL中下段碎石率及总碎石成功率高,并发症少,适用于治疗各段结石.

Comparison of the effect of ultrasound-guided ESWL and UPL in the treatment of ureteral stones

Objective To compare the effect and adverse reaction of ultrasound-guided ESWL and UPL in the treatment of ureteral stones.Methods According to the different treatment method,80 patients with ureteral stones were divided into URL group and ESWL group.The effective rate and the incidence rate of complications were compared between the two groups.Results In ESWL group,the success rate for upper gravel was 92.3%,the success rate of lower ureteral stone lithotripsy was 55.6%,there was significant difference between them（x2 =0.049,P 〈 0.05）.In UPL group,the success rate of lower ureteral stone lithotripsy was 96.0%,and the total success rate of stone was 87.5%,while those in ESWL group were 55.6% and 75.0%,the differences were significant between the two groups（x2 =0.001,0.032,all P 〈 0.05）,but there was no significant difference in the success rate of upper gravel between the two groups（P 〉 0.05）.The incidence rate of hematuria in ESWL group was 82.5%,which was significantly lower than 97.5 % in the UPL group （x2 =0.034,P 〈 0.05）.The incidence rates of fever,pain in renal region,nausea and vomiting were 17.5%,42.5%,37.5% in the ESWL group,which were significandy higher than those in the UPL group （x2 =0.023,0.033,0.004,all P 〈 0.05）.Conclusion Compared with ESWL,UPL has high success rate of lower ureteral stone lithotripsy,less complications.