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目的:评价双频双脉冲激光与钬激光碎石术治疗输尿管结石的临床疗效。方法:应用输尿管镜技术治疗870例输尿管结石患者,双频激光碎石术治疗312例(输尿管上段结石52例,中下段输尿管结石260例);以钬激光碎石术治疗558例(输尿管上段结石92例,中下段输尿管结石466例),进行疗效比较。结果:双频激光和钬激光结石总体清除率分别为92.6%(289/312)和98.4%(549/558)(P>0.05);中、下段输尿管结石上移率分别为4.2%(11/260)和1.9%(9/466);手术平均碎石时间,双频激光组为(39.8±5.4)min,钬激光组为(26.5±7.2)min(P<0.01);平均结石排净时间为(29.2±6.8)d和(18.5±4.4)d(P<0.01);钬激光组发生输尿管穿孔5例,双频激光组无穿孔发生。结论:双频激光碎石术及钬激光碎石术均为有效的碎石方法;在平均碎石时间、结石排净时间方面钬激光碎石术具有优势;双频激光碎石术在安全性方面具有优势。
Objective: To evaluate the clinical efficacy of dual-frequency dual-pulse laser and holmium laser lithotripsy in the treatment of ureteral calculi. Methods: Ureteroscopy was used to treat 870 cases of ureteral calculi, of which 312 cases were treated with dual-frequency laser lithotripsy (52 cases of upper ureteral calculi and 260 cases of middle and lower ureteral calculi); 558 cases of upper ureteral calculi 92 cases, middle and lower ureteral calculi 466 cases), the efficacy comparison. Results: The total clearance rate of dual - frequency laser and holmium laser was 92.6% (289/312) and 98.4% (549/558) respectively (P> 0.05). The upper and lower ureteral calculi movement rates were 4.2% (11 / 260 and 1.9%, respectively. The mean gravel time was (39.8 ± 5.4) min in the dual-frequency laser group and (26.5 ± 7.2) min in the holmium laser group (P <0.01) (29.2 ± 6.8) d and (18.5 ± 4.4) d respectively (P <0.01). There were 5 cases of ureter perforation in the holmium laser group and no perforation in the dual-frequency laser group. Conclusion: Dual-frequency laser lithotripsy and holmium laser lithotripsy are effective gravel methods. Holmium laser lithotripsy has advantages in terms of average gravel time and stone discharge time. Dual-frequency laser lithotripsy in safety Has advantages.