经腹侧超声定位与经背侧超声定位在输尿管上段结石体外冲击波碎石术中的应用比较

Efficacy of different ultrasound-localizing methods in extracorporeal shock wave lithotripsy for upper ureteral calculus patients

目的比较不同超声定位方法在输尿管上段结石体外冲击波碎石中的应用效果。方法选择海军总医院泌尿外科2016年5月至2017年5月收治的192例输尿管上段结石患者,按治疗方法分为试验组及对照组,每组96例。试验组采用经腹侧超声定位方法,对照组采用经背侧超声定位方法,分析2组结石至皮肤距离、定位时间、碎石效果及并发症发生情况。结果试验组≤3次碎石成功率(90.6%)高于对照组(78.1%),结石至皮肤距离[(3.7±1.4)cm]、定位时间[(5.1±2.5)min]均短于对照组[(8.1±2.3)cm、(12.3±3.1)min],差异均有统计学意义(P<0.05);2组间并发症发生情况差异无明显统计学意义(P>0.05)。结论经腹侧超声定位方法可有效地应用于输尿管上段结石的超声定位体外冲击波碎石治疗中,可缩短定位时间及冲击波与结石距离,增加定位的准确性,减少冲击波传导过程中的损耗,碎石效果更好,具有临床推广与应用价值。

To compare the efficacy of different ultrasound-localizing methods in extracorporeal shock wave lithotripsy(ESWL)on patients with upper ureteral calculi.One hundred and ninety-two patients with upper ureteral calculi admitted into the Urinary Surgical Department of the hospital for treatment from May 2016 to May 2017 were recruited as research subjects.They were divided into the experimental group and the control group in accordance with different ultrasound-localizing methods,each consisting of ninety-six patients.The experimental group was treated with the transabdominal ultrasound-localizing method,while the control group had the transback ultrasound-localizing method.The distance between calculi and skin,the ultrasound-localizing time,the treatment effect and the rate of complications were closely observed and analyzed.The success rate of lithotripsy for the experimental group was≤3 times(90.6%),which was higher than that of the control group(78.1%).In the experimental group,the distance between calculi and skin[(3.7±1.4)cm]and the ultrasound-localizing time[(5.1±2.5)min]were all significantly shorter than those of the control group[(8.1±2.3)cm,(12.3±3.1)min].There were statistical differences,when comparisons were made between them(P<0.05).However,there was no statistical significance in the rate of complications,when comparisons were made between the 2 groups(P>0.05).The transabdominal ultrasound-localizing extracorporeal shock wave lithotripsy could effectively be applied in the treatment of patients with upper ureteral calculi,with the advantages of shorter localizing time,shorter distance between calculi and skin,better accuracy,lower loss of shock wave power and better lithotriptic efficacy.For this reason,it is worth further clinical promotion.