钬激光与气压弹道碎石术治疗泌尿系结石的对比研究

[目的]比较钬激光与气压弹道碎石术治疗泌尿系结石的有效性及安全性.[方法]2005年10月至2006年2月作者采用钬激光治疗泌尿系结石,其中输尿管结石159例,膀胱结石23例.作者对钬激光的有效性及安全性与气压弹道碎石术进行了比较.[结果]159例输尿管结石中148例(93.1%)单次手术碎石成功,高于气压弹道碎石术(68.0%,87/128)(P＜0.01).膀胱结石的单次碎石成功率钬激光组显著高于气压弹道碎石组(91.3% vs. 31.3%,P＜0.01).钬激光碎石组无明显并发症发生,气压弹道碎石组有2例发生穿孔.[结论]钬激光碎石术治疗泌尿系结石安全、有效,尤其适用于结石合并息肉形成以及体外冲击波碎石无效的患者,效果明显优于气压弹道碎石法.

Comparative Study on Treatment of Urinary Calculus with Holmium:YAG Laser and Pneumatic Lithotripsy

[Objective] To compare the efficacy and safety of Holmium:YAG laser lithotripsy and pneumatic lithotripsy in the treatment of urinary calculus.[Methods] Thirty six urinary calculus patients were treated with Holmium:YAG laser lithotriptor from Oct 2005 to Feb 2007 in our unit.All of them,159 cases were ureteral calculi,and 23 cases were bladder calculi.A retrospective comparison of the efficacy and safety was made between Holmium:YAG laser lithotrips and pneumatic lithotrips.[Results]One hundred and fourty-eight cases among 159 cases of ureteral calculus(93.1%)were treated successfully with Holmium:YAG laser lithotripsy only once,and was higher than that of pneumatic lithotripsy(68.0%,87/128)(P<0.01).The successful fragmentation rate of bladder stones in a single session of the Holmium:YAG laser lithotripsy group was higher than that of the Pneumatic lithotripsy group(91.3%vs.31.3%,P<0.01).No major complication has been observed in Holmium:YAG laser lithotripsy whereas 2 perforations were encountered in pneumatic lithotripsy group.[Conclusion] Treatment of urinary calculus with Holmium:YAG laser lithotriptor is effective and safe,especially for ones with ureter polyps and failure of ESWL.