输尿管镜钬激光和体外冲击波碎石术对输尿管上段结石的疗效比较

目的:比较输尿管镜钬激光碎石术与体外冲击波碎石术(ESWL)治疗输尿管上段结石的有效性和安全性。方法:采用输尿管镜钬激光碎石术治疗输尿管上段结石72例,ESWL治疗输尿管上段结石54例,比较两组碎石成功率、结石清除率、手术时间和并发症发生率。结果:输尿管镜钬激光碎石术平均手术时间为(40±9)min,ESWL平均手术时间为(42±8)min(P>0.05);输尿管镜钬激光碎石术碎石成功率为95.83%,高于ESWL组的83.33%(P<0.05);输尿管镜钬激光碎石术3个月后结石清除率为91.67%,高于ESWL组的74.07%(P<0.05);输尿管镜钬激光碎石术组并发症发生率为5.56%(4/72),ESWL组为3.70%(2/54),两组差异无统计学意义(P>0.05)。结论:输尿管镜钬激光碎石术治疗输尿管上段结石疗效优于ESWL。

Comparison ureteroscopy with holmium:YAG laser lithotripsy and extracorporeal shock wave lithotripsy in treatment of ureteral upper calculi

Objective:To compare ureteroscopy with holmium:YAG laser lithotripsy and extracorporeal shock wave lithotripsy(ESWL) in treatment of upper ureteral calculi.Methods:Seventy-two patients underwent ureteroscopy with holmium:YAG laser lithotripsy,54 patients underwent ESWL.The operation success rate,stone-free rate,operation time and incidence rate of complications were compared between the two groups.Results:The mean operation time in ureteroscopy with holmium:YAG laser lithotripsy group was(40±9)min,in ESWL group was(42±8)min(P>0.05).The success rate was 95.83% in ureteroscopy with holmium:YAG laser lithotripsy group,which was higher than that of ESWL group(83.33%,P<0.05).Three months later the stone-free rate was 91.67%in ureteroscopy with holmium:YAG laser lithotripsy group,which was higher than that of ESWL group(74.07%,P<0.05).The complication rate was 5.56%(4/72) in ureteroscopy with holmium:YAG laser lithotripsy group,3.70%(2/54) in ESWL group(P>0.05).Conclusion:Ureteroscopy with holmium:YAG laser lithotripsy for upper ureteral calculi is more effective than ESWL.