泌尿系结石治疗方法的对比研究

目的探讨泌尿系结石各种治疗方法的疗效、安伞性及价值。方法使用体外冲击波碎石术（extracorporeal shock wave lithotripsy，ESWL）、气斥弹道碎石术（pneumatic，lithotripsy，PL）、钬激光碎石术Laser lithotripsy，LL）等方法对临床泌尿系结石病人进行治疗，然后对比研究各种治疗方法的优缺点及疗效，为泌尿系结石患者选择最佳的治疗方法。结果本组行ESWL503例、PL190例、LL322例。术后4周，3组结石清除率分别为：ESWL组72．4％（364／503）、PL组86．3％（164／190）、LL组96．6％（311／322）。LL组发生输尿管穿孔2例，PL组发牛输尿管穿孔4例，ESWL组发生石街6例。结论ESWL适用于各类泌尿系结石（肾、输尿管、膀胱结石）的治疗，具有效果好、损伤小、并发症少、费用低、痛苦少、恢复快等优点，值得在临床上积极摊广应用；LL也适用于各种结石的治疗．在碎石效率方面明显优于PL及ESWL，在安全性方面明显优于PL，是治疗输尿管结石的一种较新、高效、安全的方法，但有可能导致输尿管穿孔等不良后果；PL较适用于输尿管下段结石及膀胱结石。

Contrast studies on therapeutic methods for urinary calculi

Objective To study the therapeutic eft~cts, safety and importance of various trealment methods for urinary calculi. Methods Patients with urinary calculi were treated by extraeorporeal shock wave lithotripsy （ESWI,）, pneumatic lithotripsy （PL） and laser lithotripsy （LL） respectively, clinical data were compared and analyzed to achieve the suitahle treatment for patients with urinary calculi. Resuits 503 cases of patients with urinary calculi were treated by ESWL, 190 cases by PL, 322 cases by LL. The clearance rate of urina,-y ealculi in ESWL group was 72.4% （364/503）, PL group was 86.3% （164/ 190）, LL group was 96.6% （311/322）. Perforation was found in 2 cases of LL group, in 4 cases of PL group and steinstrasse found in 6 cases of ESWL group.Conclusions ESWL is suitable for the therapy of various urinary calculi in kidney, ureter and bladder with good treatment effect, small damage, few complications, low expenses, slight pain, early recover, ESWL is worth popularization and application in clinical treatment. LL is also a suitable treatment for urinmT calculi with better effect than PL and ESWL, and safer than PL. LL is a new, effective and safe method, hut it might increase the risk of adverse effects in perforation. PL is suitable for the therapy of urinary calculi in lower ureter and bladder.