气压弹道碎石和钬激光碎石治疗输尿管上段结石的疗效对比

A comparative study of Holmium：YAG laser lithotripsy and pneumatic lithotripsy for upper ureteral calculi

目的比较输尿管上段结石治疗中应用钬激光碎石和气压弹道碎石的疗效和安全性。方法输尿管上段结石患者211例，根据治疗方式分为：气压碎石组（PL组）97例，在输尿管镜下应用气压弹道碎石术（PL）治疗；钬激光碎石组（HL组）114例，应用钬激光碎石术（HL）治疗。观察2组患者手术成功率、手术时间和相关并发症。结果PL组和HL组一次手术成功率分别为70．1％（68／97）和90．3％（103／114），差异有统计学意义（P〈0．01）；手术时间PL组（38．5±8．2）min，长于HL组的（25．2±5．4）min（P〈0．05）。结石向上移位PL组16例，HL组5例；输尿管穿孔PL组3例，HL组2例；术后肾绞痛PL组17例，HL组2例。结论尿管上段结石的治疗中，钬激光碎石治疗效果优于较气压弹道碎石，且相对安全。

Objective To compare the clinical outcomes in management of upper ureteral calculi with holmium laser lithotripsy and pneumatic lithotripsy. Methods Out of 211 patients with upper ureteral calculi, 97 cases were treated with pneumatic lithotripsy （PL group） and 114 cases with holmium laser lithotripsy （HL group）. Comparison was made on clinical outcomes between 2 groups. Results The success rate of operation in PL group and HL group were 70. 1% and 90. 3% , respectively, with a significant difference （P 〈 0. 01 ）; Mean operation time of two groups were （38.5 ± 8.2） min and （25.2± 5.4）min, respectively, with a significant difference （ P 〈 0. 05 ）. 16 cases with Calculi moving upward in PL group and 5 cases in HL group; perforation of the ureter happened in 3 cases in PL group and 2 cases in HL group ; renal colic after operation happened in 17 cases in PL group and 2 cases in HL group. Conclusion Compared with PL, HL has greater advantages in treating the upper urethral calculi.