输尿管镜下阻挡网篮配合双频激光碎石术与ESWL治疗非复杂性输尿管上段结石疗效比较

目的：对体外震波碎石（ESWL）及输尿管镜下阻挡网篮配合双频激光碎石（URL）治疗非复杂性输尿管上段结石进行比较。探讨两种术式的疗效．方法：收治121例非复杂性输尿管上段结石病例。随机分两组．其中63例行ESWL-58例行URL,ESWL组采用多尼尔Cigma双定位体外冲击波碎石机，URL组采用Storz硬性输尿管镜，配用自制阻挡网篮，连接W．O．MU—100双频激光机后进行碎石，术后留置双J管。结果：两组在一次碎石成功率（ESWL93．7％、URI．93．1％）、术后1个月结石清除率（ESWI，90．4％．URI，93．1％）差异无统计学意义（P〈0．05），治疗时间（ESWI．33．5±6．4、URL15．0±2．3）及术后1周结石清除率（ESWL69．8％、URL93．1％）URL组要优于ESWL组．差异有统计学意义（P〈0．05）。ESWI．组出现l例包膜下血肿。URL组出现1例输尿管穿孔．结论：对非复杂性输尿管上段结石的治疗，我们要根据患者具体情况及要求，科学地制定个体化治疗方案,以减少并发症。

A Comparative Curative Effect of Non-complicated Upper Ureteral Calculi Therapy Between Stone Dislodger Combined with Double-Frequency Laser Lithotripsy under Ureteroscopy and ESWL

Objective： To explore the curative effect of non-complicated upper ureteral calculi between extracorporeal shock-wave lithotomy（ESWL）and stone dislodger combined with double-frequency laser lithotripsy under ureteroscopy（TUL）. Methods ：121 cases with non-complicated upper ureteral calculi were divided into two groups radomly. ESWL group was 63 case received therapy with Dornier Cigma double localization extracorporeel shockwave lithotripter and TUL group was 58 cases received treatment of self-made stone dislodger combined with W. O. M U-100 double-frequency laser lithotripsy placed D-J catheter post-operation under STORZ ureteroscopy. Resalts：The success rate on one session（ESWL 93. 7% ,URL 93. l%）and stone-free rate after one month （ESWL 90. 4%, URL93. 1%） are no statistical differences in two groups. There is statistical differences in two groups from treatment time （ESWL 33. 5±6. 4, URL 15. 0±2. 3） to stone-free rate after one week （ESWL 69. 8%, URL93.1 %）. URL group is better than ESWL. 1 case of renal capsular hematoma occurred in ESWL group. 1 case of ureter perforation occurred in TUL group. Conclusions： We should set individualized treatment scientifically according to the specific conditions and requirements to treat non-complicated upper ureteral calculi in order to reduce the complications.