2种体外冲击波碎石方法治疗输尿管结石108例对比分析

目的评价2种体外冲击波碎石方法治疗输尿管结石的临床疗效．方法回顾性分析2011年3月至2013年4月急性肾绞痛合并输尿管结石（结石直径〈2cm）患者108例．随机分2组其中A组69例行急诊输尿管插管定位尿路造影下体外冲击波碎石，B组39例急诊行体外冲击波碎石．结果A组：一次碎石成功63例（69例），成功率为91．33％（63／69），二次碎石成功率65例（69例）成功率为94．2％（65／69）．2例输尿管镜逆行插管失败，2例插管后结石自行排出，再发肾绞痛率14．3％（9／63），再使用镇痛药物率11．1％（7，63），B组：一次碎石成功29例（39例），成功率为74．4％（25／39），二次碎石成功率34例（39例）成功率为87．2％（34／39），5例行输尿管镜碎石取石术，再发。肾绞痛率20．5％（8／39），再使用镇痛药物率15．4％（6／39）．将A、B两组数据比较，差异有统计学意义（P〈0．05）．结论输尿管结石患者采用逆行输尿管插管尿路造影辅助定位行体外冲击波碎石治疗疗效满意．

Comparison of Two Kinds of Extracorporeal Shock Wave Lithotripsy in Treatment of 108 Cases of Ureteral Calculi

Objective To evaluate of the clinical efficacy of two kinds of methods extracorporeal shock wave lithotripsy in treatment of ureteral calculi. Methods A retrospective analysis was conducted on the data of 108 patients with acute renal colic and ureteral stones （calculi diameter 〈2 cm） from March 2011 to April 2013. The patients were divided into two groups. 69 cases in A group underwent emergency positioning urography ureteral catheterization combined extracorporeal shock wave lithotripsy, 39 cases in B group underwent emergency extracorporeal shock wave lithotripsy. Results A group： lithotripsy was successful in 63 cases among 69 cases at the first time, the first success rate was 91.33% （63/69） , the second success rate was 94.2% （65/69） , 2 cases of retrograde ureteroscopy failed, 2 cases of self-discharge after intubation stones, the recurrent renal colic rate was 14.3% （9/63）, the use of analgesic drugs rate was 11.1% （7/63） . B group：the first success rate of stone clearance rate was 74.4% （25/39） , the second success rate of stone clearance rate was 87.2% （34/39） , 5 cases underwent ureteroscopy lithotripsy, the renal colic recurrence rate was 20.5% （8/39） , the use rate of analgesic drugs was 15.4% （6/39） Conclusion Extracorporeal shock wave lithotripsy assisted by urography through retrograde ureteral catheterization has satisfying therapeutic effect in treatment of patients with ureteral calculi.