部分输尿管上段结石ESWL—URSL和直接URSL手术疗效比较

目的评价直接行输尿管镜碎石术对于部分输尿管上段结石的疗效。方法回顾性分析104例0．8～2．0cm单独性输尿管上段结石且伴肾盂中重度积水的病例，分别采用先首选体外冲击波碎石术后行输尿管镜碎石术及直接首选输尿管镜碎石两种处理组。将两组患者临床资料进行对照分析。结果两组病例具有可比性，先行ESWL组治疗时间及住院时程相对较长，而输尿管穿孔及治疗过程中转开放手术发生率相对高，差异具有统计学意义（P〈0．05）。结论对于0．8～2．0cm的单独性输尿管上段结石，输尿管上段结石部位停留时间较长伴肾盂中重度积水可首选输尿管镜碎石术。

The comparison of effect between ESWL - URSL and direct - URSL for some proximal ureteral stones

Objectives To evaluate the effect of ureteroretroscope lithotripsy for some proximal ureteral stones directly. Methods 104 cases of clinical data with 0.8 - 2.0cm solitary proximal ureteral stones and with middle or heavy hydronephrosis were retrospectively analysed. They were managed differently with first extracorporeal shockwave lithotripsy and then with ureteroretmoscope lithotripsy or with direct first ureteroretmoscope lithotripsy. Their clinical data of two groups were contrast analyzed. Results The two groups had comparability. The time of therapy and hospitalization were longer and the incidence rate of ureter performance or changing open - operation was higher in first extracorporeal shockwave lithotripsy group. The differences were statistically significant（ p 〈 0.05 ）. Conclusions For the 0.8 - 2.0cm simple proximal ureteral stones with middle or heavy hydronephrosis, we can first choose ureteroretrnoscope lithotripsy.