小切口与ESWL治疗输尿管结石的比较_临床医学论文.docVIP

小切口与ESWL治疗输尿管结石的比较_临床医学论文 小切口与ESWL治疗输尿管结石的比较_临床医学论文 【摘要】 目的：探讨小切口与体外冲击波碎石术(ESWL )治疗输尿管结石的优缺点。方法：输尿管结石患者186例,分为两组，采用小切口（小切口组）治疗104例，ESWL（ESWI组） 治疗82 例，比较两组患者结石的治愈率、并发症的发生及费用使用情况。结果：ESWL组、小切口组患者术后1个月内的结石排净率分别为63.4% 和95.2%；ESWL组再次治疗率高(11.0% ) ,但再次治疗的结石排净率为86.6%，2次ESWL平均总费用为3 012.2元。小切口组主要并发症为漏尿(26.9%)、输尿管狭窄(0.29%)，治疗总费用为3 221.6元。结论：小切口治疗输尿管结石的疗效优于ESWL。 【关键词】 输尿管结石；碎石术；外科手术；体外冲击波碎石术；小切口 ［ABSTRACT］ Objective: To investigate the advantages and disadvantages of the treatment of ureteral stones using extracorporeal shock wave lithotripsy (ESWL)and small incision. Methods: One hundred and eightsix patients with ureteral stones were divided into group A and group B according to the approaches of treatment.104 patients in group A were treated using small incision surgery, 82 patients in group B were treated using ESWL. Cure rates, complications and costs in the two group were compared. Results: Two weeks after treatment, the elimination rates of ureteral stones in group A and group B were 63.4% and 95.2% respectively. The major complication of group B was high rate of retreatment (11.0%), the elimination rate of ureteral stones was 86.6% after retreatment. The average total cost in group B was 3 012.2 yuan RMB. The major complications of group A were urine leakage(26.9%) and ureteral stenosis(0.29%), the total cost was 3 221.6 yuan RMB. Conclusion: Treating ureteral stones using small incision has better effect than that using ESWL. ［KEY WORDS］ Ureteral stones; Lithotripsy; Surgical procedures,operative; Extracorporeal shock wave lithotripsy(ESWL); Small incision 我院1999 年1月～2006 年5 月采用小切口治疗输尿管结石104例,与同期海南省人民医院采用德国Donier型体外冲击波碎石术( ESWL) 治疗输尿管结石82例进行比较,比较2种术式的特点及并发症的发生率和费用,现报道如下。 1 临床资料 1.1 一般资料 本组输尿管结石患者186例，分为两组，ESWL 组82例， 男性54例,女性28例,年龄12～78岁,平均43岁；单侧输尿管下段结石65例,双侧17 例,独肾2 例,结石直径0.6～2 cm，合并有同侧肾盂结石23 例。小切口组104例，男性61例,女性43例,年龄17～72 岁,平均年龄51岁；单侧输尿管下段结石85 例,双侧19 例,结石直径0. 5～2.3 cm ,结石梗阻急性肾功能衰竭23例,慢性肾功能不全12 例,合并有同侧肾盂结石19例,独肾或对侧肾无功能输尿管结石5 例。 1.2 治疗方法 ESWL组患者使用X 线定位,经常规输液后以