应用输尿管软镜和硬镜治疗输尿管结石的对比研究

The Comparison of Flexible Ureteroscopy and Ureteroscopy in the Treatment of Ureteral Calculi

目的:探讨应用输尿管软镜和硬镜治疗输尿管结石的优劣。方法:选取2011年6月-2013年11月在本院住院治疗的输尿管结石患者共100例,根据结石在输尿管中的位置分成输尿管上段结石组(第1组)和中下段结石组(第2组),每组组内随机分为软镜组(1A、2A组)和硬镜组(1B、2B组)并组内比较治疗效果和并发症发生情况。结果:1A组单次碎石成功率、结石排净率均明显高于1B组,手术时间长于1B组。并发症发生率明显低于1B组,2A组手术时间明显长于2B组,比较差异均有统计学意义(P<0.05)。对于直径>1.0 cm输尿管上段结石,1A组手术时间明显长于1B组,比较差异有统计学意义(P<0.05)。结论:应用输尿管软镜和硬镜治疗输尿管中下段结石,两者治疗效果无明显差异,而在治疗输尿管上段结石中,输尿管软镜已显示出良好的前景,其损伤少、痛苦小、成功率高且容易被患者所接受。随着技术和器械的不断完善,在合理选择患者的基础上,输尿管软镜可作为输尿管上段结石的首选方法之一。

Objective：To discuss the advantages and disadvantages of flexible ureteroscopy and ureteroscopy in treatment of ureteral calculi.Method：100 patients with ureteral calculi were chosen as the objects and divided into upper ureteral calculi group（group 1） and middle-lower ureteral calculi group（group 2） according to the position of calculus.Each group was randomly divided into ureteroscopy group（group 1A,1B） and ureteroscopy group（group 2A,2B）,and then the treatment effect and the incidence of complications were compared among each group.Result：The once successful lithotrity rate and the stone-free rate of group 1A were significantly higher than those of group 1B,the operative time of group 1A was longer than that of group 1B,the incidence of complications of group 1A was significantly lower than that of group 1B,the operative time of group 2A was significantly longer than that of group 2B,the differences were statistically significant（P〈0.05）.For upper ureteral calculi with diameter〉1.0 cm,the operative time of group 1A was longer than that of group 1B,the difference was statistically significant（P〈0.05）.Conclution：The treatment effects of flexible ureteroscopy and ureteroscopy have no difference in treatment of middle-lower ureteral calculi,but the flexible ureteroscopy,which causes less damage,less pain,high successful rate and easily accepted by patient,has showed better prospects than ureteroscopy in treatment of upper ureteral calculi.Flexible ureteroscopy can be one of the preferred methods in treatment of upper ureteral calculi based on proper selection of cases with the increasing development of technology and instrument.