输尿管镜下2种碎石方法治疗输尿管下段结石疗效的比较  

Comparison of effects of holmium laser and pneumatic lithotripsy under ureteroscope on ureteral calculi

作　　者：吴涛[1] 沈洪[1] 冷国雄[1] 章久武[1] 胡尚武[1] 王海波[1] 王鹏[1] 张严[1] 段涛[1] 

机构地区：[1]安徽省黄山市人民医院泌尿外科,245000

出　　处：《中华全科医学》2014年第7期1061-1062,1065,共3页Chinese Journal of General Practice

摘　　要：目的分析比较输尿管镜下钬激光与气压弹道碎石术治疗输尿管下段结石的临床效果,为临床提高输尿管镜下输尿管结石碎石术的治疗效果提供依据。方法回顾分析2012年1月—2014年2月输尿管镜下2种碎石方法治疗输尿管下段结石65例的临床资料。气压弹道组37例,年龄28~67岁,结石大小(0.5 cm×0.6cm)^(1.7 cm×1.1 cm)。钬激光组28例,年龄25~68岁,结石大小(0.8 cm×0.5 cm)^(1.8 cm×1.2 cm),术前患者均行B超、静脉注射尿路造影(IVP)、腹部平片及等检查明确诊断,比较2组手术时间、住院天数、碎石成功率。结果钬激光组及气压弹道组碎石时间分别为(37.72±13.44)min和(50.51±12.96)min,差异无统计学意义(P>0.05);2组的住院时间分别为(4.44±1.44)d和(5.53±1.69)d,差异无统计学意义(P>0.05)。碎石成功率钬激光组为96.42%(27/28),气压弹道组为89.18%(33/37),差异具有统计学意义(P<0.05)。随访3~15个月,平均8个月,1个月内结石全部排净,未出现输尿管穿孔、狭窄等并发症。结论 2种手术方式均是治疗输尿管下段结石的安全、有效方法,可作为治疗输尿管下段结石的首选方法。但是输尿管镜联合钬激光在碎石成功率方面较有的优势。熟练掌握输尿管镜操作技巧可以减少并发症的发生,值得临床推广应用。Objective To compare the clinical effects of ureterolithotripsy with holmium laser and pneumatic lithotripsy in the treatment of lower ureteral stones,and provide a reliable basis for the improvement of the treatment procedure. Methods The clinical data of 65 cases of ureteral stones receiving ureterolithotripsy in our hospital from January,2012 to February,2014 were analyzed retrospective. 37 patients in the pneumatic lithotripsy group aged 28- 67 years old with stones of 0. 5 cm × 0. 6 cm to 1. 7 cm × 1. 1 cm; while 28 patients in the holmium laser lithotripsy group aged 25- 68 years old with stones of 0. 8 cm × 0. 5 cm to 1. 8 cm × 1. 2 cm. All patients were confirmed by B ultrasound,intravenous urography（ IVP） or abdominal plain film diagnosis before the operations. The operation duration,hospitalization time and success rate of lithotripsy were compared between the two groups. Results The duration of operation in Holmium laser lithotripsy group and pneumatic lithotripsy group were（ 37. 72 ± 13. 44） min and（ 50. 51 ± 12. 96） min,respectively,there was no significant difference（ P〈0. 05）; the hospital delay in Holmium laser lithotripsy group and pneumatic lithotripsy group were（ 4. 44 ±1. 44） d and（ 5. 53 ±1. 69） d,respectively,the difference was not statistically significant（ P〈0. 05）. The success rate of lithotripsy in Holmium laser lithotripsy group and pneumatic lithotripsy group were 96. 42%（ 27 /28） and 89. 18%（ 33/37）,respectively,the difference was statistically significant（ P〈0. 05）. All patients were followed up for 3- 15 months,average 8 months; all stones were discharged in one month,no complications were found. Conclusion Ureteroscopic holmium laser and pneumatic lithotripsy are all safe and available method for lower ureteral stones,and can be preferred in the treatment of lower ureteral stones. Holmium laser lithotripsy has more advantages in the success rate as compared to the pneumatic lithotripsy. The proficient technical skills for ureter

关 键 词：输尿管结石 输尿管镜 气压弹道碎石术 钬激光碎石术 

分 类 号：R693.4[医药卫生—泌尿科学]