体外震波后行输尿管镜钬激光碎石治疗输尿管上段结石的疗效分析  

Therapeutic Effect of Ureteroscopic Holmium Laser Lithotripsy on Upper Ureteral Calculi after Extracorporeal Shock Wave

作　　者：邓体斌 李江 邵涛[1] 朱少杰[1] DENG Ti-bin;LI Jiang;SHAO Tao;ZHU Shao-jie(Department of Urology, the First People's Hospital of Qujing, Qujing, Yunnan Province, 655000 China)

机构地区：[1]云南省曲靖市第一人民医院泌尿外科,云南曲靖655000

出　　处：《中外医疗》2019年第10期90-92,共3页China & Foreign Medical Treatment

摘　　要：目的回顾性分析输尿管上段结石治疗中,体外震波碎石术(ESWL)后行输尿管镜钬激光碎石术URSL的疗效、安全性和经济效益。方法方便选取2014年12月—2016年5月间该院符合纳入标准的输尿管上段结石患者,按手术方式分为ESWL组75例、URSL组258例、ESWL+URSL组54例,对比三组患者的手术时间,排石率,手术并发症,费用等指标。结果 ESWL+URSHL组3 d排石率(88.9%)、1个月排石率(92.60%)均高于高于ESWL组(40.00%、76.00%)、URSL组(83.70%、89.90%),手术时间(58.15±12.40)min低于URSL组(64.39±14.36)min。ESWL+URSHL组未出现严重并发症,术后感染发生率降低,但同时住院费用增加。结论对不合并肾盂积水的,结石小于1.5cm的输尿管上段结石患者,体外震波后行输尿管镜钬激光碎石治疗,能够缩短手术时间,提高净石率,降低术后并发症,但同时部分患者住院时间延长,住院费用增加,ESWL后行URSHL作为常规治疗方法仍有待更大范围的前瞻性的病例对照分析。Objective To retrospectively analyze the efficacy, safety and economic benefits of ureteroscopic holmium laser lithotripsy (URSL) after extracorporeal shock wave lithotripsy (ESWL) in the treatment of upper ureteral calculi. Methods Convenient select patients with upper ureteral calculi who met the inclusion criteria in our hospital from December 2014 to May 2016 were divided into ESWL group 75 cases, URSL group 258 cases, ESWL+URSL group 54 cases, compared with the three groups, as well as the surgical time, stone discharge rate, surgical complications, costs and other indicators. Results The ESWL+URSHL group had a higher stone discharge rate (88.9%) and one month stone removal rate (92.6%) than the ESWL group (40.00%, 76.00%) and the URSL group (83.7%, 89.9%). The operation time (58.15±12.40)min was lower than that of the URSL group (64.39±14.36)min. There were no serious complications in the ESWL+URSHL group, and the incidence of postoperative infection was reduced, but the hospitalization expenses were also increased. Conclusion For patients with upper ureteral calculi with less than 1.5 cm of stones without hydronephrosis, ureteroscopic holmium laser lithotripsy after extracorporeal shock can shorten the operation time, increase the stone rate and reduce postoperative complications. At the same time, some patients have prolonged hospitalization, hospitalization costs have increased, and URSHL as a conventional treatment after ESWL remains to be subjected to a larger range of prospective case-control analysis.

关 键 词：输尿管结石 体外冲击波碎石术 输尿管镜 治疗结果 回顾性研究 

分 类 号：R699.4[医药卫生—泌尿科学]