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目的比较输尿管镜碎石(Transurethral Ureteroscopic Lithotripsy,URL)与体外冲击波碎石术(Extracorporeal Shock-Wave Lithotripsy,ESWL)治疗输尿管结石的临床疗效。方法输尿管结石患者130例,根据随机数字表分为两组:体外冲击波碎石(Extracorporeal shock-wave lithotripsy,ESWL)组,患者63例;输尿管镜碎石(Transurethral ureteroscopic lithotripsy,URL)组,患者67例。比较两组患者不同部位、直径结石的清除率和术后并发症。结果两组患者均无肾脏和输尿管周围血肿,输尿管穿孔或撕脱等并发症发生。URL组结石总清除率优于ESWL组,差异具有显著意义(P<0.05);两组患者的结石直径<1 cm的结石清除率比较,差异无显著意义(P>0.05)。ESWL组在输尿管上段结石清除率优于URL组。URL组输尿管中下段结石、直径≥1 cm结石清除率明显优于ESWL组。ESWL组上段结石清除率优于中下段;直径<1 cm结石清除率优于≥1 cm者。URL组中下段结石清除率优于上段,不同直径结石清除率差异无显著意义。结论 ESWL和URL在治疗输尿管结石时各有优势。ESWL可作为直径<1.0 cm的输尿管上段结石的首选治疗;而URL则在直径≥1 cm的输尿管中、下段结石更有优势,可作为首选治疗。
Objective To compare the clinical efficacy of transurethral Ureteroscopic Lithotripsy (URL) and extracorporeal shock-wave lithotripsy (ESWL) in the treatment of ureteral calculi. Methods One hundred and thirty patients with ureteral calculi were divided into two groups according to a random number table: 63 patients with extracorporeal shock-wave lithotripsy (ESWL) group, 66 patients with urethral lithotripsy (URL) group, example. Comparison of different parts of the two groups of patients, the diameter of stone clearance and postoperative complications. Results The two groups of patients had no renal and ureteral hematoma, ureteral perforation or avulsion complications. There was no significant difference (P> 0.05) in the stone clearance rate of stones with diameter <1 cm between the two groups (P> 0.05). ESWL group in the upper ureteral stone clearance rate is superior to the URL group. Urinary stones in the lower ureter group, diameter ≥ 1 cm stone clearance was significantly better than the ESWL group. The stone clearance rate in the upper ESWL group was better than that in the middle and lower ESWL group. The diameter of stone less than 1 cm was better than 1 cm. The clearance rate of stones in the lower part of the URL group was better than that of the upper part, and there was no significant difference in the clearance rate of stones with different diameters. Conclusion ESWL and URL have their own advantages in the treatment of ureteral calculi. ESWL can be used as the first choice for the treatment of upper ureteral stones <1.0 cm in diameter, while the lower urinary stones with URLs ≥1 cm have more advantages and may be the preferred treatment.