三种方法治疗复杂输尿管上段结石的效果对比

目的探讨三种方法治疗复杂输尿管上段结石的效果。方法 2010年1月至2012年3月收治的复杂输尿管上段结石234例,其中男性180例,女性54例;年龄32～68岁;依据治疗方法不同分为ESWL组76例,URL组78例,MPCNL组80例,观察效果。结果 ESWL组一次结石清除率46.1%,术后1月结石清除率56.6%;URL组一次结石清除率83.3%,术后1月结石清除率100%;MPC-NL组一次结石清除率100%。结论通过对3种方法进行观察,ESWL具有创伤小,但结石清除率较低;MPCNL一次结石清除率达100%,虽然创伤较小,但仍有创伤;URL具有创伤小特点,并且不需要经皮及肾盂穿刺,一次结石清除率83.3%,但术后1月结石清除率仍能够达100%;总之,在复杂输尿管上段结石如未并发输尿管狭窄、扭曲等禁忌证输尿管镜下气压弹道碎石术是首选治疗方法 ,更有利于患者的恢复及减轻痛苦。

Three methods in the treatment of complicated upper ureteral calculi effect comparison

Objective To investigate the three methods in the treatment of complicated upper ureteral calculi. Methods From 2010 January to 2012 year in March admits the complicated upper ureteral calculi in 234 cases, there were 180 males, 54 females; aged 32 ~ 68 years; according to the different treatment methods for 76 cases in ESWL group, 78 cases in URL group, MPCNL group 80 cases, observation of effect. Results In the ESWL group a stone-free rates after January 46. 1%, the stone-free rate 56. 6% ; group URL a stone-free rate was 83.3%, after January the stone-free rate 100% ; group MPCNL a stone-free rate 100%. Conclusion Through 3 kinds of methods were observed, ESWL has small wound, but the stone-free rate is low; MPCNL a stone-free rate was 100% , while the wound is smaller, but still a trauma; URL has small wound characteristics, and does not require percutaneous renal puncture and, once the stone-free rate 83.3% , but after January the stone-free rate can still amounted to 100%, in short, the complicated upper ureteral stones such as not compli- cated ureteral stricture, distortion and other contraindications ureteroscopic pneumatic ballistic lithotripsy is the preferred method of treatment, is more advantageous to the patient＇s recovery and ease the pain.