输尿管镜下钬激光和气压弹道治疗输尿管上段结石的疗效比较

目的比较输尿管镜治疗输尿管上段结石中采用钬激光和气压弹道的有效性和安全性。方法分析214例采用输尿管镜治疗输尿管上段结石,其中气压弹道碎石168例,结石直径0.8～2.5cm,并钬激光碎石46例,结石直径1.0～2.5cm,比较结石清除率、手术并发症发生率等指标的差异。结果两组中钬激光的术中结石清除率为91.3%,1个月排净率为100%;气压弹道的术中结石清除率为75.5%,术后1个月排净率为89.8%。两组间在术中结石清除率和1个月后结石排净率均有统计学差异(P<0.05),提示钬激光明显优于气压弹道。钬激光碎石术的并发症发生率6.5%,气压弹道碎石术的并发症发生率7.1%,两组间无统计学差异(P>0.05)。结论输尿管镜碎石术治疗输尿管上段结石中,钬激光在术中结石清除率及碎石效率明显优于气压弹道,且没有增加并发症的发生率,可作为治疗输尿管上段结石的首选治疗方案。

The comparative study of Holmium laser ureterlithotripsy and pneumaticlithotripsy to remove upper ureter stone

Objective To compare the efficacy and security of ureteroscopic pneumatic and holmium laser lithotripsy to remove upper ureter stone.Methods 214 patients received ureterlithotripsy were included in this study.Clinical criteria including stone clearance and postoperative complications were analyzed retrosepectively.Results In holmium laser group,the intraoperative clearance is 91.3%,and reaches 100% a month after sugery.It is siginifigantly higher than the clearance of pneumatic group,which is 75.5% during sugery and reaches 89.8% after a month.The incidence of postoperative complications shows no siginifigant difference between the two groups,which are 6.5% and 7.1% respectively.Conclusion Holmium laser reterlithotripsy has higher efficacy in upper ureter stone removement than pneumaticlithotripsy without siginificant increase of complications.