患侧肾积水大于1.5 cm的输尿管结石两种治疗方法对比分析

Comparative analysis of two treatment methods for ureterolithiasis with ipsilateral hydronephrosis greater than 1.5 cm

目的对输尿管结石患侧肾积水>1.5cm的患者进行输尿管镜下钬激光碎石取石术、体外冲击波碎石术(extracorporeal shock wave lithotripsy,ESWL)两种治疗方法进行对比分析。方法选择清华大学玉泉医院2017年3月-2018年10月间输尿管结石患侧肾积水>1.5cm的患者120例,其中行输尿管镜钬激光碎石取石术的患者60例作为观察组,行ESWL治疗的患者60例作为对照组.比较两组的治疗初期有效率、整体治疗有效率、肾绞痛、消化道症状、发热、感染性休克等并发症发生率。结果观察组治疗初期有效率达95.0%(57/60),整体治疗有效率达76.7%(46/60),高于对照组,差异有统计学意义(P<0.05);观察组并发症发生率仅6.7%(4/60),低于对照组55%(33/60),差异有统计学意义(P<0.05)。结论对于患侧肾积水大于1.5cm输尿管结石的患者.行经尿道输尿管镜钬激光碎石取石术整体治疗有效率高,且术后并发症发生率低,是治疗的第一选择。

Objective To compare and treat ureteroscopic holmium laser lithotripsy and extracorporeal shock wave lithotripsy (ESWL) in patients with hydronephrosis of ureteral calculi greater than 1.5 cm. Methods A total of 120 patients with Ureteral stones on the affected side of the hydronephrosis larger than 1.5 cm were selected from hospital from March 2017 to October 2018. Among them, 60 patients underwent ureteroscopic holmium laser lithotripsy as the observation group. Sixty patients underwent ESWL as the control group, the initial treatment efficiency, overall treatment efficiency, and the Complications (such as renal colic, gastrointestinal symptoms, fever, septic shock, etc.) were compared between the two groups. Results The initial treatment efficiency of the observation group was 95.0 %(57/ 60), and the overall treatment efficiency was 76.7%(46/60), which was higher than the control group. The difference was statistically significant (P<0.05). The Complications effect rate of the observation group was was only 6.7%(4/60), which was lower than that of the control group (55%(33/60)). The difference was statistically significant (P<0.05). Conclusion For patients with ureteral calculi with more than 1.5cm ureteral hydronephrosis, urethral ureteroscopic holmium laser lithotripsy is effective in the overall treatment, and the incidence of postoperative complications is low, which is the first choice for treatment.