输尿管结石3种治疗方法的比较

目的探讨输尿管结石治疗方法的选择。方法对经体外冲击波碎石（ESWL）、输尿管镜下钬激光碎石术及输尿管切开取石术3种方法治疗的180例输尿管结石患者疗效进行比较。结果ESWL118例，碎石率为86．4％，输尿管镜下钬激光碎石50例，一次碎石率为92％，手术切开输尿管取石12例，取石成功率为100％。输尿管镜失败改手术切开取石4例，占8％；ESWL失败改手术切开取石或输尿管镜下钬激光碎石45例，占38．1％。结论上段输尿管结石宜采用ESWL，该治疗应积极处理石街、控制感染和最大限度减轻医源性肾功能损害；中、下段输尿管结石宜采用输尿管镜下钬激光碎石术，该治疗需熟练的内镜操作技术；对于复杂性输尿管结石，开放手术仍是可供选择的重要的治疗手段。

A comparative study of 3 various means for the treatment of ureteral calculi

Objective To study and evaluate the three treatments of ureteral calculi. Methods The treatment of 180 cases of ure-teral calculi were compared by ESWL, uretemscopic Ho:YAG laser lithotripsy and open surgery. Results 118 cases were treated by ESWL (65.5%),50 cases were treated by ureteroscopic Ho:YAG laser lithotripsy (27.8%) , 12 cases were treated by open surgery (6.7%)4 cases (8%) were obliged to accept the open surgery because the ureteroscopie Ho:YAG laser lithotripsy was failure . 45 cases (38.1% ) were obliged to accept ureteroscopic Ho: YAG laser lithotripsy or open surgery because of ESWL failure . Conclusion ESWL was more suitable for the upper ureteral calculi , stone street after ESWL should be well taken care of and inflammation should be well controlled ureteroscopic Ho:YAG laser lithotripsy was more suitable for middle lower ureteral calculi , skilled technique is needed for ureteroscopic Ho:YAG laser lithotripsy. But the open surgery is still of great use for complicated stone.