钬激光碎石术与体外冲击波碎石术治疗输尿管结石疗效比较?

目的：比较输尿管镜下钬激光碎石术(URSHL)与体外冲击波碎石术(ESWL)治疗输尿管结石的临床疗效。方法将156例输尿管结石患者根据治疗方式不同分为 ESWL 组和 URSHL 组,各78例,分别行 ESWL和 URSHL 治疗。对比两组手术时间、手术并发症发生情况和术后3个月结石排净率。结果URSHL 组结石直径≤1.0 cm 和>1.0 cm 患者手术时间分别为(27.6±3.6)min 和(35.2±6.4)min,低于 ESWL 组的(41.8±5.7)min和(50.4±9.1)min,差异有统计学意义(P <0.01)。术后3个月结石排净率比较,URSHL 组总有效率为89.74%(70/78),高于 ESWL 组的76.92%(60/78),差异有统计学意义(P <0.05)。URSHL 组结石直径≤1.0 cm及>1.0 cm 患者中下段结石排净率分别为95.45%(21/22)和92.31%(24/26),高于 ESWL 组的66.67%(14/21)和74.07%(20/27),差异有统计学意义(P <0.05)。两组并发症发生率比较,差异无统计学意义(P >0.05)。结论URSHL 与 ESWL 均能有效治疗输尿管结石,对于位于中下段的结石,URSHL 治疗效果优于 ESWL。

Comparative Study Between Ureteroscopy with Holmium:YAG Laser Lithotripsy and Extracorporeal Shock Wave Lithotripsy in Treatment of Ureteral Calculi

Objective To make a comparative study between the clinical efficacy of ureteroscopy with holmium YAG laser lithotripsy (URSHL)and that of extracorporeal shock wave lithotripsy (ESWL)in treatment of ureteral calculi.Methods A total of 1 56 patients with ureteral calculi were randomly divided into ESWL group (n=78)and URSHL group (n = 78).The two groups received ESWL and URSHL treatment respectively and were compared in regard to the operation time,the incidence rate of complications and the stone-free rate three months after the treatment.Results The operation time of the patients with calculi no more than 1.0 cm and over 1.0 cm in diameter in the URSHL group is (27.6 ± 3.6)minutes and (35.2 ± 6.4)minutes respectively,while that in the ESWL group is (41.8±5.7)minutes and (50.4±9.1)minutes,which means that there is a significant difference in the operation time between the two groups (P <0.01).There is also a significant difference in the overall stone-free rate between the URSHL group (89.74%)and in the ESWL group (76.92%)(P <0.05).Among the patients with calculi no more than 1.0 cm and over 1.0 cm in diameter,the stone-free rates of middle and lower urinary tract were 95.45% and 92.31% respectively in the URSHL group and 66.67% and 74.07% respectively in the ESWL group, which suggests a significant difference (P <0.05).There was no significant difference in incidence of complications between the two groups (P >0.05).Conclusion Both URSHL and ESWL are effective in the treatment of ureteral calculi,but URSHL is more effective in treating the patients with ureteral calculi located in the middle and lower urinary tract.