上段输尿管结石经输尿管镜钬激光与经体外震波碎石术的临床探讨

Clinical application of upper segment ureteral calculi by holmium laser in the ureteroscope and extracorporeal shock wave lithotripsy

目的探讨上段输尿管结石经输尿管镜钬激光与经体外震波碎石术的临床效果情。方法分析我院2012年6月～2015年3月泌尿外科收治的上段输尿管结石患者220例临床资料，依据治疗措施不同进行临床分组，经体外震波碎石术组99例和钬激光碎石术组121例。观察两组上段输尿管结石患者手术时间、术中出血量、住院天数、尿素氮（BUN）、肌酐（cr）水平、术后疗效情况。结果钬激光碎石术组上段输尿管结石患者手术时间、术中出血量、住院天数均低于经体外震波碎石术组，差异有统计学意义（P〈0．05）。两组上段输尿管结石患者治疗前BUN、Cr水平差异无统计学意义（P〉0．05），经体外震波碎石术组和钬激光碎石术组治疗后BUN、Gr水平均低于治疗前，钬激光碎石术组治疗后BUN、Cr水平均低于经体外震波碎石术组，钬激光碎石术组上段输尿管结石患者临床治疗总有效率高于经体外震波碎石术组，差异有统计学意义（P〈0．05）。结论经输尿管镜钬激光治疗上段输尿管结石临床效果明显，创伤小，恢复快，值得临床应用。

Objective To approach clinical result of upper segment ureteral calculi by holmium laser in the ureteroseope and extraeorporeal shock wave lithotripsy. Methods 220 eases of clinical data of upper segment ureteral calculi patients in our hospital urology from June 2012 to March 2015 were analyzed. They were divided into two groups by different therapeutic measures,with 99 eases in extracorporeal shock wave lithotripsy group and 121 eases in holmium laser lithotripsy group. The operation time,intraoperative blood loss, hospital stay,BUN,Cr level,postoperative efficacy of two groups upper segment ureteral calculi patients were detected. Results The operation time,Intraoperative blood loss,hospital stay of holmium laser lithotripsy group upper segment ureteral calculi patients were lower than exiracorporeal shock wave lithotripsy group（P 〈 0.05）.The difference were statistical significance. The BUN, Cr level of two groups upper segment ureteral calculi patients before treatment were no difference（P ：〉 0.05）.The BUN,Cr level of extracorporeal shock wave lithotripsy group and holmium laser lithotripsy group after treatment were lower than before treatment. The BUN, Cr level of holmium laser lithotripsy group after treatment were lower than extracorporeal shock wave lithotripsy group（P 〈 0.05）.The difference were statistical significance. Conclusion The clinical result of treatment upper segment ureteral calculi patients by holmium laser in the ureteroscope is obviously. The injury is little, recovery is quick, and it is worth to be used.