经输尿管镜气压弹道碎石术与钬激光碎石术治疗复杂性输尿管结石的探讨（附99例病例）  

Comparison of Ureteroscopic Pneumatic lithotripsy and Holmium：YAG Laser lithotripsy in Managing complex Ureteroliths

作　　者：吴大力 晏凌飞 张瑜 王涛 钟光辉 陈海平 刘冠炤[2] WU Da-li,YAN Ling-fei,ZHANG Yu,WANG Tao,ZHONG Guang-hui＇, CHEN Hai-ping, Liu Guan-znao （ 1.Conghua Center Hospital in Guangdong Provinee,Guangzhou 510900;2.No.1 Affiliated Hospital,Guangzhou Medical College,Guangzhou 510120, China）

机构地区：[1]从化中心医院泌尿外科,广东广州510900 [2]广州医学院第一附属医院泌尿外科,510120

出　　处：《医学信息》2011年第23期315-316,共2页Journal of Medical Information

摘　　要：目的探讨和总结气压弹道碎石术与钬激光碎石术在输尿管镜治疗复杂性输尿管结石的疗效和二者的优缺点。方法回顾研究我院2007年1月至2010年12月，经输尿管镜治疗复杂性输尿管结石99例，包括合并炎性息内和内芽纽织的70例，输尿管多发性结石15例，石街9例．输尿管狭窄5例．病人入院后随机分组，气压弹道碎石组51例，钬激光碎石组48例。术后4周常规腹部平片复查结石清除率．并定义残余结石为结石大于4mm。结果气压弹道碎石的一次性鲒石碎石率48／51（94．11％），钬激光一次性结石碎石率47／48（97.91％）。两组一次性碎石成功率无统计学差异（P=0．337）；术后4周复查，气压弹道和铁激光碎石结石排净率分别为41／51（80.39％），46／48（95．83％），二者差异有显著意义（P=0.019），术后辅以体外冲击波治疗后，两组的结石清除率为（98％vs100％）。手术时间气压弹道组平均为29±5min，钬激光组为45±8min，二者差异有显著意义（P=0．018）。两组均无输尿管穿孔和大出血，术中均无中转开放。结论两者均为治疗复杂性输尿管结石安全者她的方法．钬激光碎石术的结石清除率优于气压弹道碎石术。气压弹道碎石的手术操作时间显著低于较钬激光碎石。Objective To compare and inverstigate the efficacy and merit of ureteroscopic pneumatic lithotripsy and Holmium： YAG laser lithotripsy in managing complex From January 2007 to December 2010, totally 99 patients with complex ureteroliths underwent ureteroscopic lithotripsy with Holmium： YAG laser or pneumatic lithotrlptor in our hospitaLResults The success rate of primary lithotripsy was 94.11%（48/51） in pneumatic lithotripsy group, and 97.91%（47/48）（P=0.337） in holmium laser group. Stone free rate 4 weeks after operation was 41/51 （80.39%） in the pneumatic lithotripsy group,which was significantly lower than in the Holmium laser group46/48 （95.83%）,（P=0.019）. However, the pneumatic lithotripsy group had significantly difference with Holmium laser group in operation time.（29±5min vs 45± 8min,P=0.018）. Conclusions Both Holmium laser and pneumatic litholast were safe and effective in treat complexity ureterolith. The stone free rate in holmium laser group is higher than that in pneumatic lithotripsy group. However, longer time of operation by holmium laser.

关 键 词：复杂性输尿管结石 钬激光碎石术 气压弹道碎石术 

分 类 号：R693.4[医药卫生—泌尿科学;医药卫生—临床医学;医药卫生—外科学]