输尿管镜下钬激光碎石术与气压弹道碎石术的比较

Comparative study of ureteroscope holmium laser lithotripsy and ureteroscope pneumatic lithotripsy for ureteral calculi

目的比较输尿管镜下钬激光碎石术与气压弹道碎石术治疗输尿管结石的疗效与安全性。方法回顾性分析2007年6月～2009年6月应用输尿管镜技术治疗90例输尿管结石患者的临床治疗,其中钬激光碎石术48例,气压弹道碎石术42例。结果输尿管镜下钬激光碎石术组平均术中碎石时间为9 min,明显短于气压弹道碎石术组17 min(P<0.01);输尿管镜下钬激光碎石术组碎石成功率为95.8%,明显高于气压弹道碎石术组的85.7%,两者比较差异有统计学意义(P<0.01)。输尿管镜下钬激光碎石术组无明显手术并发症,气压弹道碎石术组发生输尿管穿孔1例。结论输尿管镜下钬激光碎石术和气压弹道碎石术均是治疗输尿管结石安全、高效的方法,但输尿管镜下钬激光碎石术的有效性优于气压弹道碎石术。

Objective To compare the efficacy and safety of ureteroscope holmium laser lithotripsy（HL） and ureteroscope pneumatic lithotripsy （PL） for ureteral calculi. Methods From Jane 2007 to Jane 2009, totally 90 patients with ureteral calculi underwent ureteroscopic lithotripsy with Holmium ： YAG laser or pneumatic lithotripsy in our hospital. The data of patients were analyzed retrospectively. Results The average lithotripsy time for HL was shorter than that of PL（9min vs 17 min,P 〈0.01 ）. The successful rate of calculi fragmentation of HL was higher than that of PL（ 95.8% vs 85.7% ,P 〈0. 01 ）. No obvious complication occurred in HL group, but there was 1 case of ureter perforation in PL group. Conclusion Both HL and PL are effective and safe treatment modality for ureteral calculi,But HL has its advantage over PL in high efficiency of calculi fragmentation.