后腹腔镜与输尿管镜气压弹道碎石治疗输尿管上段结石的对比研究

Contrast Research on treatment of Ureteral Calculi with retroperitoneoscopic ureterlithotomy and Ureteroscopic Pneumatic lithotripsy

目的探讨后腹腔镜与输尿管镜气压弹道碎石治疗输尿管上段结石的效果对比。方法分别用后腹腔镜下输尿管切开取石术（A组）、输尿管镜气压弹道碎石术（B组）治疗输尿管上段结石21例、38例，回顾分析两种方法的结石清除率、并发症发生率。结果A组结石清除率为95．2％（20／21），B组为68．4％（26／38），两组之间有差异（X^2=4．21，P〈0．05）具有统计学意义；A组并发症发生率为9．5％（2／21），B组为10．5％（4／38），两组之间无显著性差异（X2=0．11，P〉0．05）。结论后腹腔镜下输尿管切开取石术是一种创伤小、恢复快、结石清除率高、安全有效的外科微创技术，在治疗输尿管上段结石方面具有一定优势；输尿管镜气压弹道碎石治疗输尿管上段结石结石清除率较低，有输尿管撕脱等较严重并发症存在。

Objective To discuss the effect comparison of treating ureteral calculi by retroperitoneoscopic ureterlithotomy and ureteroscopic pneumatic lithotripsy. Methods Adopt retroperitoneoscopic ureterlithotomy for the treatment of ureteral calculi （ Group A ）, Ureteroscopic Pneumatic lithotripsy for the treatment of ureteral calculi（ Group B ） for 21 cases and 38 cases, respectively, to review and analyses the stone clearance rate and complication incidence of the above two treatments. Results Group A＇s stone clearance rate is 95.2% （ 20/21 ）, while Group B is 68.4% （ 26/38 ）, twosets of compartment make difference （ X2= 4.21, P 〈 0.05 ） possess statistics sense; A group complication incidence for 9.5% （ 2 / 21 ）, B group for 10.5% （ 4 / 38 ）, two-sets of compartment without significant difference （ X 2= 0.11, P 〉 0.05 ）. Conclusions Laparoscopic ureterolithotomy is supposed to be a feasible and safely technique in ureteric calculus treatment, as this treatment cause minor trauma, patients can recover rapidly, and the rate for clearing stone is relatively higlg while Ureteroseopic Pneumatic lithotripsy for the treatment of ureteral calculi is with low stone clearance rate and exsits the complication indicence of Ureter remove.