气压弹道碎石术与U-100激光碎石术治疗输尿管结石的比较

A comparative study of pneumatic lithotripsy and U-100 laser lithotripsy for ureteral stones

目的比较输尿管镜下U-100激光碎石术与气压弹道碎石术治疗输尿管结石的疗效和安全性。方法总结应用输尿管镜技术治疗450例输尿管结石患者的临床资料,其中行U-100激光碎石260例,气压弹道碎石190例。结果U-100激光碎石术单次手术输尿管上段结石碎石率为93.1%(54/58),高于气压弹道碎石术的80%(44/55),P<0.05;U-100激光碎石术平均结石排净时间为18d,短于气压弹道碎石术的31d,P<0.05;U-100激光碎石组无明显手术并发症发生,气压弹道碎石组有4例发生穿孔。结论对于输尿管上段结石,U-100激光碎石术成功率高于气压弹道碎石术。U-100激光碎石术对结石推动力小,结石不易移位,对输尿管壁无损伤,出血、水肿较轻,是一种有效的腔内泌尿碎石方法。

[objective] To compare the efficacy and safety of endoscopic pneumatic lithotripsy（PL） and endoscopic U-100 laser lithotripsy （U-100） for ureteral stones. [Methods] From Mar. 2002 to Aug. 2005, 460 patients underwent endoscopic lithtripsy either with the Swiss lithoclast pneumatic lithotripsy （190 cases） or with U-100 laser lithotripsy （260 cases） for the treatment of ureteral stones. [Result] In U-100 group, 93.1% of patients whose stones situated in the upper third of the ureter were successful on the first lithotripsy,which was higher than that of PL （93.1% vs 89%, P 〈0.05）. The average stonefree time of U-100 was shorter than that of PL （18 days vs 31 days, P 〈 0.05）. No major complication was observed in U-100 group whereas 4 perforations were encountered in PL. [Conclusions] U-100 laser lithotripsy is much better than PL in effect and safety for the stones situated in the upper third of the ureter. It is a kind of laser with little damage to the soft tissues and high efficiency of lithotripsy. It is an effective, simple and reliable method for the treatment of urolithiasis.