输尿管中下段结石气压弹道碎石与体外碎石术的比较

Comparison of Ureteroscopic Pneumatic Lithotripsy and Extracorporeal Shock-wave Lithotripsy in the Treatment of Middle and Lower Ureteral Calculi

目的比较输尿管镜气压弹道碎石术(PL)与体外震波碎石术(ESWL)治疗输尿管中下段结石的疗效和安全性。方法对2216例输尿管中下段结石患者经输尿管镜下气压弹道碎石术(PL)和体外震波碎石(ESWL)治疗的临床疗效及并发症进行比较。结果 PL组单次碎石成功率93.2%,ESWL组为56.1%,差异有统计学意义(P<0.05);PL组4周后结石排净率为97.0%,ESWL组为67.8%(P<0.05)。术后疼痛、发热、恶心呕吐、血尿是两组常见的并发症,PL组术后疼痛、发热发生率低,分别为3.6%、3.0%,两组比较,差异有统计学意义(P<0.05)。结论输尿管镜气压弹道碎石术治疗输尿管中下段结石的疗效明显优于ESWL。

Objective To compare the therapeutic effect and safety of ureteroscopic pneumatic lithotripsy （PL） and extracorporeal shock-wave lithotripsy （ESWL） in the treatment of middle and lower ureteral calculi. Methods The clinical effect and incidence of complications of PL and ESWL in the treatment of 2216 cases of middle and lower ureteral calculi were compared. Results The single stone clearance rate of PL group and ESWL group was 93.2%, 56.1%, respectively （P〈0.05）. The stone free rate of PL group and ESWL group in 4 weeks was 97.0%, 67.8%, respectively （P〈0.05）. The common complications occurred in both groups in-cluded postoperative pain, fever, nausea and vomiting, and hematuresis. The incidences of postoperative pain and fever in the PL group were lower, which was 3.6%and 3.0%, respectively, the differences between the two groups were statistically significant （ P〈0.05）. Conclusion For middle and lower ureteral calculi, the efficacy of ureteroscopic pneumatic lithotripsy is significantly better than that of ESWL.