不同体位体外冲击波碎石术治疗输尿管上段结石的临床效果

Clinical efficacy of extracorporeal shock wave lithotripsy in different positions in treatment of upper ureteral calculi

目的采用不同体位体外冲击波碎石术(ESWL)治疗输尿管上段结石的临床疗效。方法 120例输尿管上段结石患者行ESWL,其中60例患者(A组)采用俯卧位,60例患者(B组)采用仰卧位。记录两组第1、2次治疗后以及治疗后1个月时的无石率(SFR),观察治疗后早期并发症发生情况。结果 B组第1、2次治疗后及治疗后1个月时SFR均高于A组(76.7%vs.56.7%、86.7%vs.71.7%及90.0%vs. 75.0%)(P<0.05)。两组患者治疗后均未出现肾脏血肿;两组间肾绞痛、肉眼血尿、石街和尿路感染患者比例比较差异均无统计学意义(P>0.05)。结论与俯卧位比较,采用仰卧位行ESWL对输尿管上段结石击打更为高效、精准,且患者耐受性较好。

Objective To observe the clinical efficacy of extracorporeal shock wave lithotripsy(ESWL)in different positions in the treatment of upper ureteral calculi.Methods One hundred and twenty patients with upper ureteral calculi were treated with ESWL,who were asked to take prone position(group A,60 cases)or supine position(group B,60 cases).The stone-free rates after the 1st and 2nd treatment and in the 1st month after treatment were recorded.The short-term complications after treatment were observed in both groups.Results The stone-free rates after the 1st and 2nd treatment and in the 1st month after treatment were higher in group B than those in group A(76.7%vs.56.7%,86.7%vs.71.7%and 90.0%vs.75.0%)(P<0.05).The renal hematoma after treatment did not occur in both groups.There were no statistical differences in the proportions of the patients with renal colic,gross hematuria,ureteric stone street and urinary tract infection between groups of A and B(P>0.05).Conclusion Compared to prone position,ESWL in supine position is more effective and precise in treating upper ureteral stones with better tolerance of patients.