输尿管镜下钬激光碎石与气压弹道碎石治疗输尿管结石的疗效比较

Comparison of Efficacy of Ureteroscopic Holmium Laser Lithotripsy vs Pneumatic Lithotripsy for the Treatment of Ureteral Calculi

【目的】比较输尿管镜下钬激光碎石（LL）与气压弹道碎石（PL）治疗输尿管结石的疗效，为临床选择最佳的治疗方法提供依据。【方法】本院2009年1月至2011年12月应用输尿管镜下LL或PL治疗输尿管结石患者299例，其中采用LL151例，PL148例。比较两组的碎石时间、一次性碎石成功率及并发症发生率。【结果】LL组在平均碎石时间、并发症发生率分别为（34．5±4．6）min和0．67％，明显低于PL组的（39．8±5．5）min和4．73％；而LL组的一次性碎石率则高于PL组，分别为92．05％和81．76％；差异均有统计学意义（P均〈0．05）。【结论】输尿管镜下钬激光碎石术治疗输尿管结石的效果和安全性较气压弹道碎石术具有一定的优势，是一种较为安全有效的碎石方法。

[Objective] To compare the efficacy of ureteroscopic holmium laser lithotripsy（LL） vs pneu- matic lithotripsy（PL） for the treatment of ureteral calculi so as to provide the basis for the clinical selection of the best treatment method. [Methods]The clinical data of 299 patients with ureteral calculi undergoing uret- eroscopic LL or PL from Jan. 2009 to Sept. 2011 were retrospectively analyzed. In all patients, 151 patients underwent LL and 148 patients underwent PL. The gravel time, stone-free rate and the incidence of complica- tions were compared between two groups. [Results] The average gravel time and the incidence of complica- tions in group LL were lower than those in group PL（34.5±4.6rain vs 39.8±5.5min, 0.67% vs 4.73%）. However,the one-time stone-free rate in group LL was higher than that in group LL（92.05% vs 81. 76%）. There were significant differences（ P 〈0.05）. [Conclusion] The efficacy and safety of ureteroscopic LL for the treatment of ureteral calculi are better than LL, so it is a safe and effective method of stone fragmentation. It can also treat ureteral calculi complicated by polyp or strictures at the same time. Therefore, it is worthy of clinical promotion.