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目的探讨体外冲击波碎石术、输尿管镜钬激光碎石术及微创经皮肾镜碎石术治疗输尿管上段结石疗效对比。方法回顾性分析2009年6月至2010年8月,收治的236例输尿管上段结石患者的临床资料。结果 236例中,采用体外冲击波碎石术(ESWL)治疗113例,输尿管镜钬激光碎石术(URL)66例,微创经皮肾镜碎石术(MPCNL)57例,分别占总数的47.8%、27.9%和24.3%。结果 URL组、ESWL组、MPCNL组结石清除率分别为76.9%(87/113)、87.8%(58/66)、96.4%(55/57);清石率MPCNL最高。ESWL出现的并发症发生率最低。结论 ESWL在治疗输尿管上段结石方面有损伤轻、出现并发症的几率小的特点,但单用时结石清除率也相对较低;PCNL是对合并肾结石的输尿管结石的治疗最理想的选择。
Objective To compare the efficacy of extracorporeal shock wave lithotripsy, ureteroscopic holmium laser lithotripsy and minimally invasive percutaneous nephrolithotripsy in the treatment of upper ureteral calculi. Methods The clinical data of 236 patients with upper ureteral calculi admitted from June 2009 to August 2010 were retrospectively analyzed. Results Of the 236 patients, 113 were treated with extracorporeal shock wave lithotripsy (ESWL), 66 were ureteroscopic holmium laser lithotripsy (URL), 57 were minimally invasive percutaneous nephrolithotomy (MPCNL), accounting for a total of 47.8%, 27.9% and 24.3%. Results The stone clearance rate of the URL group, the ESWL group and the MPCNL group were 76.9% (87/113), 87.8% (58/66) and 96.4% (55/57), respectively. The incidence of ESWL complications is the lowest. Conclusions ESWL has the characteristics of light injury and small complication rate in the treatment of upper ureteral calculi. However, the removal rate of ESWL alone is relatively low. PCNL is the best choice for the treatment of ureteral stones with renal calculi.