经输尿管镜钬激光及弹道碎石治疗输尿管上段结石临床分析

Clinical Contrast Research on Treatment of Upper Ureteral Stones with Holmium Laser and Pneumatic Lithotripsy

目的总结经输尿管镜下钬激光及弹道碎石治疗输尿管上段结石的临床疗效。方法选择180例输尿管上段结石患者,其中87例采用输尿管镜气压弹道碎石术(对照组),93例采用输尿管镜钬激光碎石术(治疗组),分别记录两组结石净石率、1月净石率、手术时间、住院时间并进行统计学分析,比较两组种手术方法的治疗效果。结果一次性碎石净石率钬激光组为88.2%,气压弹道组为77.0%,一次性碎石成功率差异有统计学意义(P<0.05);手术时间钬激光组显著短于气压弹道组(P<0.05);住院时两组比较差异无统计学意义(P>0.05);术后1月,结石排净率钬激光组为95.7%,气压弹道组为86.2%,两组结石排尽率差异有统计学意义(P<0.05)。结论对于输尿管上段结石的治疗,钬激光碎石较气压弹道碎石术更安全、有效。

Objective To evaluate the difference of clinical efficacy of holmium laser and pneumatic lithotripsy for upper ureteral calculi. Methods 180 patients with upper ureter calculi were selected in this study, including 87 cases of pneumatic lithotripsy （control group）, and 93 cases of ureteroscopic holmium laser lithotripsy （treatment group）. The surgical procedures, the stone free rate, the stone free rate after one month, the operation time and the hospital stay of two groups were recorded and compared, and statistical analysis was carried out. Results The free stone rate of treatment group after lithotrity was 88.2%, while 77.0% in control group, the difference was significant （P 〈0.05）. The operation time of the holmium laser group was significantly shorter than that of the pneumatic lithotripter group （P〈0.05）, and there was no significant difference in the hospital stay between the two groups （P 〉0.05）. The free stone rate of treatment group after one month was 95.7%, and 86.2% in control group, with statistically significant difference（P〈0.05）. Conclusions Holmium laser lithotripsy is safer and more effective than pneumatic lithotripsy in the treatment of upper ureteral calculi.