钬激光碎石术与体外冲击波碎石术治疗输尿管不同部位结石的临床研究(1)
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[摘要] 目的 比较钬激光碎石术(LL)与体外冲击波碎石术(ESWL)治疗不同部位输尿管结石的优劣。方法 ESWL组66例患者采用体外冲击波术，LL组66例患者采用钬激光碎石术。 结果 LL组患者上段结石残留率明显高于ESWL组，中下段结石残留率明显低于ESWL组，LL组患者平均治疗时间明显短于ESWL组；LL组患者血尿、膀胱刺激、结石上移、输尿管穿孔发生率明显高于ESEL组，肾绞痛和发热发生率明显低于ESWL组(P<0.05)。 结论 上段结石ESWL效果更好，中下段结石LL疗效更佳。
[关键词] 钬激光碎石术；体外冲击波碎石术；输尿管结石
[中图分类号] R699 [文献标识码] B [文章编号] 1673-9701(2011)36-51-02
Clinical Study of Holmium Laser Lithotripsy and Extracorporeal Shock Wave Lithotripsy for Treating Different Parts of Ureteral Stones
ZHENG Bin WEN Haitao TANG Chunbo ZHU Weizhi QI Yong WANG Gang ZHOU Youfeng
Urology Department, Urinary kidney hospital of Ningbo City, Zhejiang Province， Ningbo 315100, China
[Abstract] Objective To compare the pros and cons of holmium laser lithotripsy (LL) and extracorporeal shock wave lithotripsy (ESWL) treating in different parts of ureteral stones. Methods All of 66 cases in ESWL Group were treated by extracorporeal shock wave lithotripsy and 66 cases in LL Group were treated by holmium laser lithotripsy. Results The upper stone residual rate of LL Group 12.5% was significantly higher than ESWL Group, the middle and lower stone residual rate of LL Group was significantly lower than ESWL Group. The average hospital stay time of LL Group was longer than ESWL Group. The complications rate of hematuria, bladder irritation, move stones, ureteral perforation in LL Group were significantly higher than ESWL Group, and complications rate of renal colic and fever were lower than ESWL Group(P<0.05). Conclusion ESWL had better effects in upper stones and LL had better effects in middle and lower stones.
[Key words] Holmium laser lithotripsy; Extracorporeal shock wave lithotripsy; Ureteral stones
体外冲击波碎石术(ESWL)是目前临床较常用的输尿管碎石技术，其具有创伤小、痛苦小、操作简便、费用低廉等特点[1]，但临床表明，由于其体外排石的特点，部分结石仍然较难排出。随着医疗技术的不断发展，近些年来，钬激光碎石术(LL)逐渐被应用于临床[2]，并受到了一定的认可。但两种术式在输尿管不同部位的结石治疗中疗效及并发症如何，目前尚少有研究。本文选取我院2010年1~12月间输尿管结石患者共132例进行ESWL与LL对不同部位的治疗优劣性比较研究，现报道如下。
1 资料与方法
1.1 临床资料
132例患者临床表现为肉眼或镜下血尿，部分伴有脓尿，均经影像学检查并确诊为输尿管结石。其中上段结石48例，中下段84例；男性72例，女性60例；年龄最小21岁，最大66岁，平均(42.3±5.2)岁；结石直径范围0.8～2.3cm。将所有患者随机分为ESWL组和LL组，各66例，ESWL组上段结石30例 ......
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