ESWL与URSL治疗输尿管中下段结石的评价与选择

目的:探讨体外冲击波碎石(ESWL)和输尿管镜下弹道碎石(URSL)治疗输尿管中下段结石的临床疗效。方法:回顾分析ESWL和URSL治疗输尿管中下段结石524例,540侧的临床资料。结果:ESWL组结石排净率92.5%,并发症发生率4%(血尿除外),URSL组的结石排净率为94.7%,并发症发生率为6.5%。结论:对停留时间短、X线显示清晰、诊侧肾功能好的结石首选ESWL,对停留时间长、X线显示模糊、与骶髂骨重叠、诊侧肾功能较差,则首选URSL,对复杂的输尿管中下段结石,两者协同使用,两者均失败,则需及时开放手术治疗。

The evaluation and election of ESWL and URSL in treating the urinary calculus of middle and inferior segment ureter

Objective The aim of the study was to explore the of therapeutic effect of urinary calculus of middle and inferior segment ureter by using the extracorporeal shock-wave lithotripsy(ESWL)and the ureteroscope lithotripsy(URSL). Method To retrospectively analyse the clinical data of 524 patients with urinary calculus of middle and inferior segment ureter and 540 sides urinary calculus. Results The clearance rate of urinary calculus in ESWL group was 92.5%, the incidence rate of complication was 4%( except hematuria) , the clearance rate of urinary calculus in URSL group was 94.7%, the incidence rate of complication was 6.5%. Conclusion Both of ESWL and URSL can be used to treat the urinary calculus of middle and inferior segment ureter, the ESWL can be firstly selected to treat the patients with well renal function and the urinary calculus which can be clearly displayed in X-Ray and has shorter residence time in ureter, the URSL can be used to treat the patients with worse renal function and the urinary calculus which cannot be clearly displayed in X-Ray or overlap with sacroiliac, and the urinary calculus has longer residence time in ureter, ESWL can be used in coordination with URSL in treating the complicate urinary calculus of middle and inferior segment ureter, openning operation need be promptly used to treat the urinary calculus if ESWL and URSL cannot get better therapeutic effect.