输尿管镜下超声与气压弹道碎石术治疗输尿管上段结石并急性梗阻性尿毒症的比较

Comparison of clinical effect between ultrasound and ureteroscopy pneumatic ballistic lithotripsy in the treatment of upper ureteral calculi with acute obstructive uremia

目的比较输尿管镜下超声碎石术与气压弹道碎石术治疗并发急性梗阻性尿毒症的输尿管上段结石的临床疗效及其优缺点。方法回顾性分析我院2009年5月至2012年5月的104例输尿管上段结石并发急性梗阻性尿毒症患者的临床资料。采用输尿管镜下超声碎石术(组1)和输尿管镜下气压弹道碎石术(组2)治疗的患者各52例,统计并比较两组的住院时间、手术时间、术中出血量、结石清除率及并发症发生情况。结果两组患者术后肾功能均在短期内恢复正常,组1与组2相比较,组1结石清除率高、手术时间短、住院时间短、术后感染率低,组间比较差异有统计学意义(P<0.05)。两组均无输尿管穿孔、撕脱等并发症。结论输尿管镜下超声碎石术治疗输尿管上段结石并发急性梗阻性尿毒症是一种安全、有效的理想手术方法,不增加手术并发症。

Objective To compare the clinical effectiveness,advantages and disadvantages of the treatment of upper ureteral calculus with acute obstructive uremia by ultrasound and ureteroscopy pneumatic ballistic lithotripsy.Methods Clinical data of 104 cases treated with ultrasound and ureteroscopy pneumatic ballistic lithotripsy from May 2009 to May 2012 were analyzed retrospectively.The patients were divided into group one and group two,respectively received ultrasound and ureteroscopy pneumatic ballistic lithotripsy.Clinical data including the hospital stay,operative time,blood loss,stone clearance rate and complications were compared.Results The blood urea nitrogen （BUN） and Cr returned to normal in 104 cases after operation in a short term.The clinical effects of the two methods were similar,but compared with ureteroscopy pneumatic ballistic lithotripsy,ultrasound lithotripsy had the higher stone clearance rate,shorter operation time,less hospital stay,and less postoperative infection （P〈0.05）.Two groups had no severe complication were observed such as ureteral perforation or ureteral avulsion.Conclusion The ultrasound lithotripsy is safe and effective in the treatment of upper ureteral calculus with acute obstructive uremia,that does not increase the operation complication.