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目的:比较钬激光与气压弹道碎石治疗输尿管中下段结石并息肉的有效性及安全性。方法:回顾性分析我院2006年1月~2012年12月输尿管镜下治疗输尿管结石患者的临床资料,钬激光碎石组90例,气压弹道碎石组88例,比较两组手术时间、结石排净率及输尿管狭窄的发生率等。结果:两组均无中转开放病例。钬激光碎石一次性粉碎率为100%,一次性取净率为97.8%(88/90);气压弹道碎石一次性粉碎率为100%,一次性取净率为95.5%(84/88)。钬激光碎石组与气压弹道碎石组结石清除率的差异无统计学意义(P>0.05)。但钬激光组输尿管穿孔率为8.9%(8/90),气压弹道组为1.1%(1/88);钬激光组出现输尿管狭窄率为11.1%(10/90),气压弹道组仅2.3%(2/88),差异均有统计学意义(P<0.05)。结论:输尿管镜下钬激光碎石术和气压弹道碎石术均可有效治疗合并息肉形成的中下段输尿管结石,但气压弹道碎石术的安全性更高。
Objective: To compare the efficacy and safety of holmium laser and pneumatic lithotripsy in the treatment of lower ureteral stones and polyps. Methods: The clinical data of patients with ureteral calculi treated by ureteroscopy from January 2006 to December 2012 in our hospital were analyzed retrospectively. 90 cases were treated by holmium laser lithotripsy and 88 cases were treated by pneumatic lithotripsy. The operative time, Discharge rate and the incidence of ureteral stricture. Results: There were no cases of transfer to open in both groups. Holmium laser lithotripsy rate of 100% disposable, one-time take-off rate was 97.8% (88/90); Pneumatic lithotripsy disposable smash rate was 100%, one-time take-off rate was 95.5% (84/88 ). Holmium laser lithotripsy group and pneumatic lithotripsy stone clearance rate difference was not statistically significant (P> 0.05). However, the ureter perforation rate was 8.9% (8/90) in the holmium laser group and 1.1% (1/88) in the pneumatic ballistic group. The ureteral stricture rate was 11.1% (10/90) in the holmium laser group and only 2.3% in the pneumatic ballistic group (2/88), the differences were statistically significant (P <0.05). Conclusions: Both ureteroscopic holmium laser lithotripsy and pneumatic lithotripsy are effective in treating the lower and middle ureteral stones formed by polyps, but the pneumatic lithotripsy is more safe.