急诊输尿管镜碎石术与ESWL治疗输尿管中下段结石并急性肾绞痛的疗效评价  

Evaluation of efficacy between emergency ureteroscopy lithotripsy and extracorporeal shock wave lithotripsy in management of middle or lower ureteral calculi with acute renal colic

作　　者：王征[1] 刘锋[1] 谢军[1] 杨洋[1] 陈鹏[1] 耿进成[1] 

机构地区：[1]乌鲁木齐 新疆医科大学第五附属医院,新疆830011

出　　处：《国际泌尿系统杂志》2014年第2期164-167,共4页International Journal of Urology and Nephrology

摘　　要：目的 比较急诊输尿管镜下气压弹道碎石术（ureteroscopic lithotripsy,URSL）与体外冲击波碎石术（extracorporeal shock wave lithotripsy,ESWL）治疗输尿管中下段结石并急性肾绞痛的疗效.方法 回顾性分析本院近3年来45例急诊URSL（URSL组）以及51例急诊ESWL（ESWL组）治疗输尿管中下段结石并急性肾绞痛患者的临床资料,比较其疼痛缓解率、一次性碎石成功率、术后2周结石排净率、并发症发生率等指标.结果 URSL组和ESWL组疼痛缓解率分别为95.56％（43/45）和78.43％（40/51）（P＜0.05）,URSL组一次性碎石成功率和术后2周碎石排净率分别为93.33％ （42/45）、97.78％ （44/45）,明显优于ES-WL组的78.43％ （40/51）、82.35％（42/51）（P＜0.05）;URSL组术后有2例发生尿路感染,ESWL组术后有4例发生肉眼血尿,两组术后均未出现发热、输尿管穿孔、撕裂等并发症（P＞0.05）.结论 对于结石直径＞l0mm的输尿管中下段结石并急性肾绞痛患者,急诊输尿管镜术疗效优于体外冲击波碎石术;首选输尿管镜术治疗此类患者具备一定的临床推广价值.Objectives To compare the efficacy and complication of emergency ureteroscopy lithotripsy（URSL） and extracorporeal shock wave lithotripsy（ESWL） in management of middle or lower ureteral calculi with a-cute renal colic.Methods 45 cases with middle or lower ureteral calculi were treated with emergency URSL（URSL group） and 51 cases with middle or lower ureteral calculi were treated with ESWL （ESWL group）.Clinicaldata of two groups,which came from our hospital the last three years,were analyzed retrospectively.To compare thesuccess rate of lithotripsy,pain release,clearance rate of stones after two weeks and complication incidence of the twogroups.Results The success rates of postoperative pain release,disposable lithotripsy,clearance of stones aftertwo weeks in URSL group were higher than that in ESWL group （95.56% vs 78.43%,93.33% vs 78.43%,97.78% vs 82.35%,respectively,P 〈 0.05）.2 urinary tract infections were encountered in URSL group whereas 4 ca-ses in ESWL group suffered from macroscopic haematuria.There is no significant statistical difference between twogroups in complication,such asmacroscopic haematuria,ureter perforation,ureter tear,fever,urinary tract infectionand so on（P 〉 0.05）.Conclusions URSL is the better choice than ESWL for middle or lower ureteral calculiwith acute renal colic.so preferred ureteroscopy surgery has a certain clinical value of popularization in managementof those stones,which are longer than 10 mm in their diameter.

关 键 词：输尿管结石 输尿管镜检查 碎石术 

分 类 号：R693.4[医药卫生—泌尿科学]