输尿管镜和ESWL治疗小儿输尿管结石的临床疗效比较

Effect comparison of ureteroscope treatment and extracorporeal shock wave lithotripsy in children with ureteral stone

目的比较输尿管镜气压弹道碎石(URSL)与体外冲击波碎石(ESWL)治疗小儿输尿管结石的临床疗效。方法回顾性分析120例输尿管结石患儿的临床资料,根据治疗方法的不同将患者分入URSL组(58例)与ESWL组(62例)。结果 URSL组与ESWL组碎石成功率分别为93.1%和90.3%,4周后结石排净率分别为91.4%和88.7%,两组碎石成功率及结石排净率均无显著差别(P>0.05);URSL组与ESWL组输尿管中下段碎石成功率分别为100.0%和86.7%,结石排净率分别为96.4%和80.0%,URSL组显著优于ESWL组(P<0.05);URSL组输尿管上段碎石成功率显著低于ESWL组(86.7%vs 93.8%,P<0.05),结石排净率亦显著低于ESWL组(86.7%vs 96.9%,P<0.05)。结论治疗小儿输尿管结石应根据具体情况选择治疗方案,对于上段结石ESWL效果更佳,对于输尿管中下段结石,应采用URSL治疗。

Objective To compare the effect of ureteroscope pneumatic lithotrity（URSL） and extracorporeal shock wave lithotripsy（ESWL） in children with ureteral stone.Methods 120 dates of children with ureteral stone were retrospectively analyzed.120 patients were divided into URSL group（58 cases） and ESWL group（62 cases） according to different treatment method.Results The success rates of fragmentation were 93.1% and 90.3%,and the stone-free rates 4 weeks after treatment were 91.4% and 88.7% in URSL group and ESWL group respectively without significant difference（P〈0.05）;The success rates of fragmentation of middle-lower ureteral were 100.0% and 86.7%,and the stone-free rates were 96.4% and 80.0% in URSL group and ESWL group respectively（P〈0.05）;The success rate of fragmentation of upper ureter in URSL group was much lower than ESWL group（86.7% vs 93.8%,P〈0.05）,and the stone-free rate was greatly decreased（86.7% vs 96.9%,P〈0.05）.Conclusion Treatment protocols for children with ureteral stone should be chosen according to concrete conditions.ESWL has better effects for upper ureter and URSL is suitable to middle-lower ureteral.