输尿管镜和ESWL治疗输尿管中下段结石的比较

A COMPARATIVE STUDY OF TRANSURETHRAL URETEROSCOPY PN EUMATIC LITHOTRIPSY AND EXTRACORPOREAL SHOCK WAVE LITHOTRIPSY FOR THE TREATMEN T OF MIDDLE AND LOWER URETERAL CALCULI

目的 :比较经输尿管镜气压弹道碎石术 (TUPL)与体外冲击波碎石术 (ESWL)治疗输尿管中下段结石的结石排净率和并发症 ,方法 :总结治疗输尿管中下段结石 40 2例的临床资料 ,其中TUPL组 2 17例 ,ESWL组185例。结果 :TUPL组术后第 4周结石排净率为 95.9% ,高于ESWL组的 81.1% ,P <0 .0 1;TUPL组主要并发症为输尿管穿孔或粘膜严重损伤 ( 4 .1% ) ,ESWL组主要并发症为再次治疗率高 ( 13 .5% )。结论

Objective:To compare the efficacy and c omplication of transurethral ureteroscopy pneumatic lithotrips y (TUPL ) and extracorporeal shock wave lithotripsy (ESWL) for the treatment of middle and lower ureteral calculi.Methods:From Sept. 1998 to Aug. 2002, 402 patients unde rwent either with TUPL (217 cases) or with ESWL (185 cases) for t he treatment of middle and lower ureteral calculi.Results:The stonefree rate after 4 weeks of TUPL was higher than that of ESWL (95.9% vs 81.1%, P <0.01) . TUPL cause d perforation or mucosal severe injury of ureters in 4.1%, and ESWL had a retreatment rate of 13.5% of patients. Conclusions:TUPL has its advantage over ESWL in high er stonefree rate and lower retreatment rate for middle and lower ureteral calculi whereas TUPL has more perforations or muco sal severe injuries than ESWL.