冲击波碎石与输尿管镜治疗上尿路结石的临床研究

目的 比较研究冲击波碎石（SWL）与输尿管镜（URS）在治疗上尿路结石的临床疗效,以进一步提高疗效,减少并发症.方法 将收录的69例结石直径在5～20mm的上尿路结石患者随机分为两组,分别施以冲击波碎石（SWL）术和输尿管镜（URS）术,以比较研究两术的临床疗效.比较研究的指标有年龄,性别,结石清除率,治疗情况和结石直径等.结果 SWL组平均手术时间显著小于URS组（60.2±15.9min vs 86.9±32.5min,P〈0.01）;术后3个月的追踪研究表明,对SWL组和URS组患者进行X光诊断,结果显示两组患者的结石清除率分别为94.1%和88.6%,并且SWL组的生活质量优于URS组.结论 综合研究显示,SWL治疗中等大小上尿路结石具有比URS较优的临床疗效,并且实施SWL术后患者并发症发生率及恢复时间明显少于URS,显示SWL治疗中等大小匕尿路结石的显著优势.

Shock Wave Lithotripsy and Ureteroscopy for Upper Urinary Calculi in Clinical Research

Objective To compare shock wave lithotripsy（SWL） and ureteroscopy（URS） for the treatment of patients with upper urinary tract stones in a prospective,randomized,multicenter trial. Methods A total of 69 patients with 5 - 20mm urinary tract stones were randomized to SWL or URS.The two groups were comparable with respect to age,sex, SFR,side treated and stone diameter.Results Operative time was significantly shorter for SWL than URS（60.2 ＋ l 5.9 minutes vs 86.9 ＋ 32.5 minutes）.At 3 months of followup the patients who underwent SWL and URS had radiographic followup that demonstrated a stone-free rate of 94.1% and 88.6%,respectively. Patient derived quality of life measures favored SWL.Conclusion It shows that the better clinical efficacy, the better choice of SWL in the treatment of urinary tract stones for its great advantage in shorten recovery time and lower complication rate comparing to URS.