ESWL与输尿管镜治疗输尿管中下段结石的比较

目的比较体外冲击波碎石术(ESWL)与输尿管镜下气压弹道碎石术(TUPL)治疗输尿管中下段结石的结石粉碎率、排净率和并发症.方法输尿管中下段结石患者292例,ESWL组132例,TUPL组160例.结果 ESWL组结石一次粉碎率90%(119/132),TUPL组结石一次粉碎率100%(155/155)(P＜0.05);两组患者术后1个月的结石排净率分别为78.1%和99.4%(P＜0.05);ESWL组的主要并发症为再次治疗率高(18.9%),而输尿管镜组的主要并发症为输尿管狭窄(2.5%).结论 TUPL不仅能作为ESWL失败的替代治疗,还可作为输尿管中下段结石的首选治疗手段.

Comparison between effectiveness of lower and middle ureteric calculi treated by ESWL and that by TUPL

Objective: To compare the effectiveness of lower and middle ureteric calculi treated by ESWL and that by TUPL. Methods: 292 cases of lower and middle ureteric calculi were divided into two groups: ESWL group (n=132) and TUPL group (n=160). Results: For lower and middle ureteric calculi resulted in a stone-free rate in ESWL group was 90% while 100% in TUPL group (P<0.05). Stone-free rate a month later in ESWL group and in TUPL group was 78.1% and 99.4% respectively (P<0.05). Main comlplication in ESWL group was had a retreatment(18.9%) while in TUPL group was ureterostenosis (1.25%). Conclusion: For the management of lower and middle ureteric calculi, TUPL might be a first method and might deal with the retreatment in patients treated by ESWL.