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目的探讨三种方法治疗复杂输尿管上段结石的效果。方法 2010年1月至2012年3月收治的复杂输尿管上段结石234例,其中男性180例,女性54例;年龄32～68岁;依据治疗方法不同分为ESWL组76例,URL组78例,MPCNL组80例,观察效果。结果 ESWL组一次结石清除率46.1%,术后1月结石清除率56.6%;URL组一次结石清除率83.3%,术后1月结石清除率100%;MPC-NL组一次结石清除率100%。结论通过对3种方法进行观察,ESWL具有创伤小,但结石清除率较低;MPCNL一次结石清除率达100%,虽然创伤较小,但仍有创伤;URL具有创伤小特点,并且不需要经皮及肾盂穿刺,一次结石清除率83.3%,但术后1月结石清除率仍能够达100%;总之,在复杂输尿管上段结石如未并发输尿管狭窄、扭曲等禁忌证输尿管镜下气压弹道碎石术是首选治疗方法 ,更有利于患者的恢复及减轻痛苦。
Objective To investigate the effect of three methods on the treatment of complex upper ureteral calculi. Methods A total of 234 patients with complex ureteral calculi in our hospital from January 2010 to March 2012 were enrolled, including 180 males and 54 females, ranging in age from 32 to 68 years old. According to the different treatment methods, 76 cases were divided into ESWL group, 78 cases of URL group, 80 cases of MPCNL group, observe the effect. Results The primary stone clearance rate was 46.1% in ESWL group and 56.6% in January. The primary stone clearance rate in the URL group was 83.3% and the stone clearance rate was 100% in January. The primary stone clearance rate in the MPC-NL group was 100%. Conclusions ESWL has the advantages of less trauma and lower stone clearance by observing the three methods. The primary stone removal rate of MPCNL is 100%. Although the trauma is small, there are still traumatic injuries. The URL has traumatic characteristics and does not need to be traced Skin and pelvis puncture, a stone clearance rate of 83.3%, but the stone clearance rate after January can still reach 100%; In short, in the upper ureteral calculi, such as the absence of complications such as ureteral stenosis, torsion and other ureteroscopic pneumatic lithotripsy Surgery is the preferred treatment, more conducive to the recovery of patients and reduce pain.