输尿管结石不同治疗方法的单次治疗成功率比较

目的 体外震波碎石（extracorporeal shockwave lithotripsy,ESWL）及输尿管镜取石术（ureteroscopic lithotripsy,UL）是输尿管结石的主要治疗方式,比较不同治疗方式间的单次治疗成功率,选择最佳治疗方式.方法 选择2012年9月-2013年9月就诊于我院需要外科干预的输尿管结石患者114例,对其治疗方式及预后进行分析.结果 114例中77例行体外震波碎石,30例行输尿管镜取石术,7例行后腹腔镜输尿管切开取石术.单次治疗成功率ESWL为64.9％,UL为84.3％,腹腔镜手术为100％.UL单次成功率高于ESWL（P=0.042）.结论 建议输尿管镜取石术为输尿管结石治疗的首选方式;对于病程短、结石直径＜ 1cm的输尿管结石,治疗可考虑ESWL;腹腔镜手术作为微创手术是上两种方式的必要补充.

Single treatment success rate of different methods in treatment of ureteral calculi： A comparative study

Objective To investigate the treatment of ureteral calculi and select optimum modality between the methods in treatment of ureteral calculi by comparing the single treatment success rate.Methods Surgical procedure and prognosis of 114 outpatients and inpatients with ureteral calculi admitted to our hospital from September 2012 to September 2013 were retrospectively investigated and analyzed.Results Seventy-seven cases had accepted extracorporeal shockwave lithotripsy （ESWL）（67.5%）,30 cases had accepted ureteroscopic lithotripsy （26.3%）,7 cases had accepted retroperitoneal laparoscopic ureterolithotomy （6.2%）.Their single treatment success rate was 64.9%,84.3% and 100% respectively.There was statistical difference between ESWL and ureteroscopic lithotripsy in the single treatment success rate （P=0.042）.Conclusion In view of single treatment success rate,it is suggested that ureteroscopic lithotripsy is the first choice and that indication for ESWL is suited for ureteral calculi with short duration,diameter 〈 1 cm and that laparoscopic ureterolithotomy as a minimally invasive mean is a necessary supplement for the two means mentioned above.