输尿管结石通过输尿管镜钬激光碎石术和体外冲击波碎石术治疗的不同效果

Different Effects of Ureteroscopic Holmium Laser Lithotripsy and Extracorporeal Shock Wave Lithotripsy on Ureteral Calculi

目的对比体外冲击波碎石术与输尿管镜钬激光碎石术治疗输尿管结石的临床疗效。方法从2015年4月—2018年1月我院收治的输尿管结石患者中选取97例,按照随机数字表法分为两组,对照组患者49例,采用体外冲击波碎石术治疗,试验组患者48例,采用输尿管镜钬激光碎石术治疗,对比两组结石排净、并发症发生情况以及手术时间。结果对照组直径<1 cm的结石排净率为91.30%,试验组为88.89%,组间差异无统计学意义,χ2=0.066 9,P> 0.05;试验组直径≥1 cm结石排净率为80.00%,高于对照组的53.85%,组间差异有统计学意义,χ2=4.368 2,P <0.05;与对照组对比,试验组结石直径<1 cm与直径≥1 cm患者的手术时间均更短,组间差异有统计学意义,t=128.693 9、63.636 8,P <0.05;对照组并发症发生率为4.08%(2/49),试验组为6.25%(3/48),组间差异无统计学意义,χ2=0.233 2,P> 0.05。结论体外冲击波碎石术与输尿管镜钬激光碎石术治疗直径<1 cm的输尿管结石疗效相当,但输尿管镜钬激光碎石术的手术时间更短,治疗直径≥1 cm输尿管结石的结石排净率更高。

Objective To compare the clinical effects of extracorporeal shock wave lithotripsy and ureteroscopic holmium laser lithotripsy in the treatment of ureteral calculi.Methods From April 2015 to January 2018,97 patients with ureteral calculi in our hospital were selected and divided into two groups according to random number table.49 patients in control group were treated with extracorporeal shock wave lithotripsy and 48 patients in study group were treated with ureteroscopic holmium laser lithotripsy.And the stone clearance rate,incidence of complications and operation time was compared.Results The clearance rate of ureteral calculi<1 cm in diameter in control group was 91.30%and 88.89%in study group.There was no significant difference between the two groups,χ^2=0.066 9,P>0.05.The clearance rate of ureteral calculi≥1 cm in diameter in study group was 80.00%,higher than 53.85%in control group.There was significant difference between the two groups,χ^2=4.368 2,P<0.05.The operation time of ureteral calculi<1 cm and≥1 cm in diameter was shorter in study group,t=128.693 9,63.636 8,P<0.05.The incidence of complications was 4.08%(2/49)in control group and 6.25%(3/48)in study group.There was no significant difference between the two groups,χ^2=0.233 2,P>0.05.Conclusion Extracorporeal shock wave lithotripsy is as effective as ureteroscopic holmium laser lithotripsy in the treatment of ureteral calculi<1 cm in diameter,but ureteroscopic holmium laser lithotripsy has shorter operation time and higher stone clearance rate for ureteral calculi≥1 cm in diameter.