摘要
目的探讨输尿管结石的最佳治疗方法。方法将我院收治的300例输尿管结石患者随机分为三组，分别采用原位体外冲击波碎石（ESWL）、输尿管镜钬激光碎石（URLL）与输尿管切开取石术3种方法治疗。将此三组的疗效进行比较。结果ESWL150例，碎石率为89.3％（134／150）；输尿管镜下碎石术120例，一次碎石率为95．8％（115／120）；手术切开输尿管取石30例，取石成功率100％。输尿管镜失败改切开取石8例，占6．7％；ESWL失败改切开取石或输尿管镜下碎石54例，占36．0％。结论输尿管上段结石首选原位ESWL，URLL治疗输尿管结石可以避免开放手术对患者造成的痛苦，减少术后并发症。输尿管切开取石术虽然创伤大，但它是一切输尿管手术的基础。
Objective to discuss how to make the best treatment of ureteral calculi. Methods the 300 cases ureteral calculi treated in our hospital were randomly divided into three groups,comparing the effect of treatment with each other： in-situ extracorporeal shack wave lithotriptor （ESWL）, ureteroscopic laser lithotripsy （URLL） and ureteralithotomy. Results ESWL 150 cases, got 89.3% （134/150） lithotriptic effect; URLL 120 cases, got 95.8%（115/120） lithotriptic effect; ureterolithotomy 30 cases, stone-free 100%. 8 cases account for 6.7% got ureterolithotomy because of failling of URLL; 54 cases got URLL or ureterolithotomy due to failling of ESWL, account for 36.0 %. Conclusion the upper tract of ureteral calculi preferred ESWL in situ, URLL can greatly reduce pain and postoperative complications by open operation; ureterolithotomy, although causing more body injury, it is the foundation of all ureteral surgery.
