ESWL与输尿管镜治疗输尿管下段结石的比较

Treatment of lower ureteric calculi:extracorporeal shock-wave lithotripsy vs pneumatic ureteroscopy.A comparison of effectiveness and morbidity

目的 :比较体外冲击波碎石术 (ESWL)与输尿管镜治疗输尿管下段结石的结石排净率和并发症。方法 :治疗输尿管下段结石患者 390例 ,其中用 ESWL治疗 2 1 0例 ,输尿管镜治疗 1 80例。结果 :两组患者术后 1个月的结石排净率分别为 78.1 %和 93.3% (P <0 .0 5) ;ESWL组的主要并发症为再次治疗率高 (1 1 .9% ) ,而输尿管镜组的主要并发症为输尿管穿孔 (3.3% )。结论 :输尿管镜治疗输尿管下段结石的疗效优于 ESWL组。

Purpose:To determine the efficacy and morbidity of extracorporeal shock-wave lithotripsy (ESWL) compared with pneumatic ureteroscopy (URS) in the treatment of lower ureteric calculi. Methods:From August,1997 to June,1999,treatment with ESWL included 210 patients with lower ureteric calculi.URS was used in 180 patients with lower ureteric calculi,stones were fragmented with a pneumatic lithotripter.The outcome was assessed by stone-free rates,re-treatment rates and complication.Results:ESWL for lower ureteric calculi resulted in a stone-free rate of 78.1 %,compared with 93.3 % for URS,P< 0.05 .ESWL had a re-treatment rate of 11.9 %,and URS caused perforation of ureters in 3.3 % of patients.Conclusion:For the management of lower ureteric calculi,ESWL provides a noninvasive,simple and safe option,and URS has a higher stone-free rate and more perforation of ureters than ESWL.