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目的:对体外震波碎石(ESWL)及输尿管镜下阻挡网篮配合双频激光碎石(URL)治疗非复杂性输尿管上段结石进行比较,探讨两种术式的疗效。方法:收治121例非复杂性输尿管上段结石病例,随机分两组,其中63例行ESWL,58例行URL,ESWL组采用多尼尔Cigma双定位体外冲击波碎石机,URL组采用Storz硬性输尿管镜,配用自制阻挡网篮,连接W.O.M U-100双频激光机后进行碎石,术后留置双J管。结果:两组在一次碎石成功率(ESWL 93.7%、URL 93.1%)、术后1个月结石清除率(ESWL 90.4%、URL 93.1%)差异无统计学意义(P<0.05),治疗时间(ESWL 33.5±6.4、URL 15.0±2.3)及术后1周结石清除率(ESWL 69.8%、URL93.1%)URL组要优于ESWL组,差异有统计学意义(P<0.05)。ESWL组出现1例包膜下血肿,URL组出现1例输尿管穿孔。结论:对非复杂性输尿管上段结石的治疗,我们要根据患者具体情况及要求,科学地制定个体化治疗方案,以减少并发症。
OBJECTIVE: To compare ESWL and ureteroscopic barrier baskets with dual-frequency laser lithotripsy (URL) in the treatment of non-complex upper ureteral calculi and to explore the efficacy of the two surgical procedures. Methods: A total of 121 patients with uncomplicated upper ureteral calculi were enrolled and randomly divided into two groups, of which ESWL was performed in 63 cases and URL in 58 cases. Urinary Cromma double positioning ESWL was used in ESWL group and Storz rigid ureter in URL group. Mirror, with homemade barrier basket, connect WOM U-100 dual-frequency laser machine after gravel, double J tube after surgery. Results: There was no significant difference between the two groups in the success rate of primary gravel (ESWL 93.7%, URL 93.1%) and stone clearance rate (ESWL 90.4%, URL 93.1%) at one month after operation (P <0.05) (ESWL 33.5 ± 6.4, URL 15.0 ± 2.3) and stone clearance rate after 1 week (ESWL 69.8%, URL 93.1%) were superior to ESWL group (P <0.05). One case of subcapsular hematoma occurred in ESWL group and one case of ureter perforation in URL group. Conclusion: For the treatment of non-complex upper ureteral calculi, we need to formulate individualized treatment plans scientifically to reduce complications according to patients’ specific conditions and requirements.