不同方法治疗泌尿系复杂肾结石的效果比较

目的比较体外冲击波碎石(Extracorporeal shock-wave lithotripsy,ESWL)联合输尿管镜、微创配合气压弹道联合超声碎石取石术治疗复杂肾结石的疗效。方法95例复杂结石患者采用ESWL联合输尿管镜治疗,101例复杂结石患者采用微创配合气压弹道联合超声碎石取石术治疗。治疗后评估结石清除率,随访4个月观察结石排出情况。比较两种方法的优缺点。结果ESWL联合输尿管镜组结石清除率93.6%,排净率91.0%;微创配合气压弹道联合超声碎石取石术治疗组结石清除率95.1%,排净率99%。结论微创手术是治疗是治疗复杂肾结石的首选,尤其在对于大的复杂肾结石;对较大鹿角形肾结石者先行微创手术再看残留结石情况决定是否行Ⅱ期微创手术或行ESWL。

Comparison on the different therapies for treatment of complex renal calculi

Objective To study the efficacy of ureteroscopy in combination with extracorporeal shock-wave lithotripsy,ESWL and minimally invasive ultrasound with pneumatic lithotripsy united lithotomy in the treatment of complex renal calculi.Method The 95 cases with complex calculi were subjected to ureteroscopy in combination with ESWL treatment;101 cases to minimally invasive ultrasonic united pneumatic lithotripsy.The stone-free rate for the discharge of calculus was evaluated after the treatment and follow-up of 4 months.Then the advantages and disadvantages of both methods were compared each other.Result The stone free rate and the net rate were 93.6%,91.0% in ESWL group and 95.1%,99% in minimally invasive group respectively.Conclusion Minimally invasive surgery is the first choice for the treatment of complex renal calculi,particularly in the case of large complex renal calculi.For the bigger staghorn calculi the minimally invasive surgery first should be chosen,then the phase Ⅱ minimally invasive surgery or ESWL was chosen according to the situation of residual calculus.