输尿管镜下气压弹道碎石术治疗输尿管结石的可行性及安全性

The feasibility and safety of ureteroscopic pneumatic lithotripsy in treatment of ureteral calculus

目的 评价输尿管镜下气压弹道碎石术治疗输尿管结石的临床效果及安全性.方法 选取2006年6月～2013年12月本院收治的输尿管结石患者156例,随机分为观察组和对照组各78例,观察组采用输尿管镜下气压弹道碎石术治疗,对照组采用体外冲击波碎石术治疗,观察并比较两组输尿管不同部位结石的成功率及不同部位术后并发症的发生率.结果 观察组上段结石总有效率为75.00％,中下段结石总有效率为94.83％,合计总有效率为89.74％;对照组上段结石总有效率为88.89％,中下段结石总有效率为71.67％,合计总有效率为75.64％.观察组上段结石总有效率低于对照组,中下段结石总有效率高于对照组,合计总有效率高于对照组,差异有统计学意义（P＜0.05）.两组并发症发生率差异无统计学意义（P＞0.05）.结论 对于输尿管中下段结石应首选输尿管镜下气压弹道碎石术,而输尿管上段结石应结合患者的具体情况加以选择.

Objective To evaluate the clinical efficacy and safety of ureteroscopic pneumatic lithotripsy in treatment of ureteral calculus. Methods 156 patients with ureteral calculus treated in our hospital from June 2006 to December 2013 were selected and were randomly divided into observation group and control group with 78 cases in each group, the observation group were treated with ureteroscopic pneumatic lithotripsy,the control group were taken with the treatment of extracorporeal shock wave lithotripsy,the success rate of ureteral calculus in different parts and postoperative complications of different parts of the two groups were observed and compared. Results In observation group,the total effective rate of upper ureteral calculus was 75.00%,of middle and distal ureteral calculus was 94.83%,the total effective rate was 89.74%;in the control group,the total effective rate of upper ureteral calculus was 88.89%,of middle and distal ureteral calculus was 71.67%,the total effective rate was 75.64%;the total effective rate of upper ureteral calculus in observation group was lower than that of control group,of middle and distal ureteral calculus was higher than that of control group,the total effective rate was higher than that of control group,the difference was significant （P〈0.05）.The occurrence of complications between the two groups had no significant difference （P〉0.05）. Conclusion For middle and distal ureteral calculus should carry out ureteroscopic pneumatic fithotripsy,and upper ureteral calculus should choose appropriate surgery according to the specific circumstances of patients.