微创治疗输尿管结石3种不同方法比较(附326例报告)  

Three minimally invasive approaches for treatment of ureteral calculi:a comparative analysis of 326 cases

作　　者：肖耀军[1] 邵志强[2] 张明[1] 王海坤[1] 王建平[1] 黄谷[1] 李彬[1] 

机构地区：[1]武警广东总队医院泌尿外科,广东广州510507 [2]山东省临沂市人民医院泌尿外科,山东临沂276003

出　　处：《南方医科大学学报》2009年第7期1448-1450,共3页Journal of Southern Medical University

摘　　要：目的比较体外冲击波碎石术(ESWL)、输尿管镜碎石(URL)、经皮肾镜碎石术(PCNL)治疗输尿管结石疗效及优缺点。方法回顾分析2006年1月至2008年10月分别采用ESWL、URL、PCNL术治疗输尿管结石326例的临床资料。结果三种方法碎石成功率分别为78.5%(146/186),91.2%(93/102)和100%(38/38)。ESWL组结石直径分别为0.5～0.99cm,1.0～2.0cm,>2.0cm三组,碎石成功率分别为90.8%(89/98)、69.3%(52/75)、30.8%(5/13),3组比较差异有统计学意义(P<0.01);URL组3例入镜困难,5例结石上移肾盂,1例结石残留,发生输尿管穿孔2例;PCNL组均1期建立经皮肾通道并碎石成功,结石清除率为100%,无气胸、腹腔脏器损伤等严重并发症发生。结论ESWL最佳适应症是<1cm输尿管结石;URL适合大多数输尿管结石,特别是中下段结石,入镜成功是碎石成功的前提,结石返肾是导致失败的主要原因;PCNL处理输尿管上段大的梗阻性结石有优势,特别是ESWL、URL失败病例。Objective To compare the therapeutic effect of 3 minimally invasive approaches for ureteral calculi removal and analyze their respective advantages and limitations.Methods A retrospective analysis was conducted in 326 patients receiving extracorporeal shock wave lithotripsy(ESWL),ureteroscopic lithotripsy(URL) or percutaneous nephrolithotripsy(PCNL) for ureteral calculi.The clinical data including the stone-free rate and complications were analyzed.Results The stone free rate was 78.5%(146/186),91.2(93/102)...

关 键 词：输尿管结石 体外冲击波碎石 输尿管镜碎石 经皮肾镜碎石 微创 

分 类 号：R699[医药卫生—泌尿科学]