输尿管镜下钬激光碎石术治疗输尿管阴性结石的临床分析

Clinical analysis on ureteroscopic holmium laser lithotripsy treating ureteral negative calculi

目的观察输尿管镜下钬激光碎石术治疗输尿管阴性结石的临床效果。方法选取本院自2009年3月～2012年1月收治的98例输尿管阴性结石患者按照随机数字表法随机分为观察组与对照组各49例，观察组采用输尿管镜下钬激光碎石术治疗，对照组给予中药排石冲击联合枸橼酸氢钾钠（友来特）治疗，比较两组患者的排石效果。结果（1）观察组平均手术时间为（41．2±8．4）min，术后平均住院时间为（3．6±1．2）d，术后平均（15．1±3．4）d拔除双J管，结石排净率为97．9％（46／47），对照组结石排净率为80．9％（38／47）。观察组结石排净率明显高于对照组（Х^2=15．025，P〈0．01），具有统计学意义。（2）两组患者并发症及不良反应情况比较无明显差异（Х^2=1．136，P〉0．05），无统计学意义。（3）6—18个月的随访观察，观察组复发2例，复发率为4．1％。对照组复发7例，复发率为14．3％。观察组复发率明显低于对照组（Х^2=-13．754，P〈0．01），具有统计学意义。结论采用输尿管镜下钬激光碎石术治疗输尿管阴性结石效果较佳，且具有安全性高、易恢复、复发率低等优点，值得推广应用。

Objectives To observe the clinical effect of ureteroscopic holmium laser lithotripsy treating ureteral negative calculi. Methods According to random number table, 98 patients with ureteral negative calculi treated in our hospital from March 2009 to January 2011 were divided into 2 groups randomly, the observation group and the control group, each group for 49 cases. The observation group were given the treatment of ureteroseopic holmium laser lithotripsy, and the control group were treated with traditional Chinese medicine row stone impact co -mbined with potassium sodium hydrogen citrate or Uralyt - U. Removing effect of 2 groups were compared. Results （ 1 ） As for the observation group, the average operation time was（41.2 ± 8.4 ） min, the average length of stay after operation was（ 3.6 ± 1.2 ）d, Double J tube was removed for average （15.1 ±3.4 ）d after operation, and the stone free rate was 97.9% （46/47）. The stone free rate of the control group was stone free rate. The stone free rate of the observation group was higher evidently than that of the control group（ X2 = 15. 025, P 〈 0.01 ）, which had statistical significance. （2） There was no evident difference between 2 groups as for the complications and adverse reactions （ Х^2 = 1.136, P 〉 0.05 ） , which had no statistical significance. （3） The patients were followed up for 6 - 18 months. And there were 2 patients with recurrence and the recurrence rate was 4.1% in the observation group. As for the control group, there were 7 patients with recurrence and the recurrence rate was 14.3%. The recurrence rate of the observation group was lower evidently than that of the control group（ Х^2 = - 13. 754, P 〈0.01 ） , which had statistical significance. Conclusions Ureteroscopie holmium laser lithotripsy treating ureteral negative calculi not only has better effect , but also has the advantages of high safety, recoverability and low recurrence rate, which is worthy of application in clinical practice.