ESWL联合输尿管镜钬激光碎石治疗输尿管结石临床分析  

Clinical study on treatment of ureteral calculi with extracorporeal shock wave lithotripsy and ureteroscopy holmium: YAG laser lithotripsy

作　　者：赵长永[1] 李道兵[1] 罗成功 田德美[1] Zhao Changyong Li Daobing Luo Chenggong Tian Demei(Department of Urinary Surgery, Affiliated Hospital of Zunyi Medical University, Zunyi Guizhou 563099, Chin)

机构地区：[1]遵义医学院附属医院泌尿外科,贵州遵义563099

出　　处：《遵义医学院学报》2016年第5期515-517,共3页Journal of Zunyi Medical University

摘　　要：目的评价体外冲击波(Extracorporeal shock wave lithotripsy;ESWL)联合输尿管镜下钬激光碎石与单纯输尿管镜钬激光碎石,治疗输尿管结石的疗效与安全性。方法收集2014年1月至2015年12月我院输尿管结石患者的临床资料,筛查出ESWL+输尿管镜下钬激光碎石的30例,单纯输尿管镜下钬激光碎石的30例;记录各自的手术时间、术后出血及结石残余情况,术后留置尿管时间,患者住院时间等临床指标进行统计分析。结果两组患者术前情况基本一致,结石直径(11.27±2.45)mm VS(11.53±2.89)mm,差异无统计学意义(P>0.05)。ESWL+URL组在手术时间(37.00±14.93)min VS(52.43±23.27)min,术后留置尿管时间(2.43±1.33)d VS(3.47±1.14)d及住院时间(7.53±2.29)d VS(9.93±2.79)d均优于单纯行URL组,差异有统计学意义(P<0.05)。术后结石残余(0例VS 2例),术后出血(0例VS 1例)差异无统计学意义(P>0.05)。结论 ESWL联合输尿管镜下钬激光碎石治疗输尿管结石,尤其是中上段结石较单纯输尿管镜钬激光碎石在缩短手术时间,减少术中结石漂移、降低术中冲水压,缩短平均住院日等方面都具有显著优势。Objective To compare the safety and efficacy of the ESWL combined with ureteroscopy holmium：YAG laser lithotripsy for ureteral calculi. Methods Collected clinical data of patients with ureteral calculi from January 2014 to December 2015 in our hospital. Select 30 cases of ESWL ＋ holmium laserlithotripsy under ureter mirror,pure holmium laser lithotripsy under ureter mirror 30 cases; The operation time,postoperative bleeding and residual stone,indwelling catheter time,hospital stay and other clinical indexes were analyzed. Results The preoperative condition of the two methods were pretty much the same,the stone diameter（ 11. 27 ± 2. 45） mm VS（ 11. 53 ± 2. 89） mm showed no statistically difference（ P〉0. 05）. In the operation time（ 37. 00 ± 14. 93）min VS（ 52. 43 ± 37. 00） min,indwelling catheter time（ 2. 43 ± 1. 33） days VS（ 3. 47 ± 1. 14） days and hospital stay（ 7. 53 ± 2. 29） days VS（ 8. 70 ± 2. 29） days in experimental groups were better than control groups,differences between the two groups were significant（ P〈0. 05）. Theresidual stone rate（ 0 VS 2 cases）,postoperative bleeding（ 0 v 1 cases） showed no statistically difference between the two groups（ P〉0. 05）. Conclusion In the treatment of ureteral calculi,especially proximalureteral calculi,extracorporeal shock wave lithotripsy（ ESWL） and ureteroscopy holmium： YAG laser lithotripsy,could obviously shorten the operation time and indwelling catheter time,reduce the stone shifting,and lower intrapelvic pressure.

关 键 词：输尿管结石 输尿管镜 钬激光 体外冲击波碎石 

分 类 号：R693[医药卫生—泌尿科学]