经输尿管镜钬激光碎石术治疗输尿管结石患者的临床观察

Clinical observation of ureteroscopic holmium:YAG laser lithotripsy for patients with ureteral stones

目的:探讨经输尿管镜钬激光碎石术治疗输尿管结石患者的临床疗效。方法:临床纳入输尿管结石患者90例,根据碎石方案的不同分为研究组与对照组,研究组患者进行经输尿管镜钬激光碎石术(LL),对照组患者进行体外冲击波碎石术(ESWL)。比较两组患者手术时间、术后3个月结石排净率等。结果:研究组患者治疗>1.0 cm与≤1.0 cm结石所需要的时间均短于对照组(P<0.05);研究组术后3个月>1.0 cm结石排净率为91.67%,对照组患者为68.00%,差异有显著性(P<0.05);研究组患者输尿管中下段术后3个月结石排净率为92.59%,对照组患者为72.00%,差异有显著性(P<0.05)。结论:体外冲击波碎石术适用于直径≤1.0 cm的输尿管上段结石,输尿管镜钬激光碎石术适用于直径>1.0 cm的输尿管中下段结石。

Objective： To study clinical efficacy of ureteroscopic holmium：YAG laser lithotripsy for patients with ureteral stones. Methods：90 ureteral stone patients were divided into study group and control group according to the different lithotripsy schemes. The study group received ureteroscopic holmium：YAG laser lithotripsy （ LL） , while the control group received extracorporeal shock wave lithotripsy （ ESWL） . The operation time and the stone clearance rate 3 months after the treatment of the two groups were compared. Results：For the stones〉1. 0 cm and≤1. 0 cm, the operation time of study group was shorter than that of control group （P〈0. 05）. For the stones 〉1. 0 cm, the stone clearance rates 3 months after the treatment of study group and control group were 91. 67% and 68. 00%, respectively, and the difference was significant （P〈0. 05）. For the stones in middle and lower ureter, the stone clearance rates 3 months after the treatment of study group and control group were 92. 59% and 72. 00%, respectively, and the differ-ence was significant （P〈0. 05）. Conclusions：For the stones in the upper ureter and with a diameter of≤1. 0 cm, ESWL is superior to LL;however, for the stones in middle and lower ureter and with a diameter of 〉1. 0 cm, LL is more suitable.