ESWL与输尿管镜下碎石术治疗肾及输尿管上段结石疗效比较.docVIP

ESWL与输尿管镜下碎石术治疗肾及输尿管上段结石疗效比较 　　[摘要] 目的 比较体外震波碎石（ESWL）与输尿管镜下碎石术（URSL）治疗肾及输尿管上段结石的疗效和不良反应。 方法 选择2010年1月～2012年12月间951例肾及输尿管上段结石的患者，786例采用ESWL治疗，165例采用URL治疗，对两组患者的结石清除率、发热及血尿并发症等进行分析比较。 结果 ESWL组结石清除率显著高于URL组（80.9% vs 55.8%，P 0.01）；在发热及血尿并发症方面，ESWL组显著低于URL组。 结论 体外冲击波碎石对于治疗肾及输尿管上段结石疗效明确。 　　[关键词] 体外冲击波碎石术；肾结石；输尿管上段结石；输尿管镜碎石 　　[中图分类号] R691.4 [文献标识码] B [文章编号] 1673-9701（2013）34-0146-02 　　Clinical analysis of ESWL treatment on 786 cases with renal and upper ureteral calculi 　　WU Deli 　　Department of Urology， Jiangsu Provincial Integration of Chinese and Western Medicine Hospital， Nanjing 210028， China 　　[Abstract] Objective To compare the efficacy and side effects of extracorporeal shock wave lithotripsy（ESWL） and transurethral ureteroscopic lithotripsy（URL） in the kidney and utter ureteral calculi. Methods A total of 951 cases were diagnosed as kidney and utter ureteral calculi during January 2010 to December 2012， of which 786 received ESWL and the other 165 received URL. The stone free rate， side effects such as fever and hematuria were compared between two groups. Results The efficacy rate for kidney and utter ureteral calculi treated with ESWL was significantly higher than that of URL （80.9% versus 55.8%， P 0.01）. The side effects such as fever and hematuria in ESWL group were lower than those in URL group （P 0.01）. Conclusion Extracorporeal shock wave lithotripsy is a good means for the treatment of renal and upper ureteral calculi. 　　[Key words] ESWL；Kidney calculi；Upper ureteral calculi；URS 　　尽管目前治疗泌尿系结石的方法较多， 体外冲击波碎石术（extracorporeal shock wave lithotripsy，ESWL）仍是临床治疗肾及输尿管上段结石的主要手段之一[1，2]。我院于2010 年1月～2012 年12月对951例肾及输尿管上段结石患者分别采用ESWL及输尿管镜碎石（transurethral ureteroscopic lithotripsy，URL）治疗，对其疗效及并发症进行比较，现总结如下。 　　1 资料与方法 　　1.1 临床资料 　　按治疗方法分为ESWL组和输尿管镜碎石组。其中ESWL组786例，男497例，女289例，年龄15～82岁，平均42岁。影像学检查肾结石301例，其中左肾结石156例，右肾结石145例，输尿管上段结石416例，输尿管上段结石合并肾结石69例。其中21例为行经皮肾镜钬激光碎石术后残余结石，13例为行经输尿管镜钬激光碎石术后残余结石。结石横径6～18 mm， 纵径5～16 mm。URL组选择同期我院行输尿管镜碎石术的肾及输尿管上段结石病例165例，男