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目的评价输尿管下段结石患者经输尿管镜下气压弹道碎石术(URSL)治疗的临床疗效。方法以随机非盲法为标准将170例符合标准的输尿管下段结石患者归入两组试验,Ⅰ组85例接受体外冲击波碎石术(ESWL)治疗,Ⅱ组85例接受URSL手术碎石,对比评估两组的一次碎石成功率、术后4周排石率及围术期并发症发生率。结果Ⅱ组的一次碎石成功率为94.1%,术后4周排石率为96.5%,相比Ⅰ组的61.2%和75.3%均显著提高,比较差异显著(P<0.05)。两组围术期均有出现发热、恶心/呕吐等并发症,但总并发症率相比,差异不显著(P>0.05)。结论对输尿管下段结石患者应用URSL术治疗,手术一次碎石成功率高,排石较彻底,且安全性有保障,可作为今后临床治疗输尿管结石的一种推荐手术方式。
Objective To evaluate the clinical efficacy of ureteroscopic pneumatic lithotripsy (URSL) in patients with lower ureteral calculi. Methods One hundred and seventy patients with lower ureteral calculi under randomized non-blinded method were divided into two groups: 85 cases in group I received ESWL, 85 cases in group II received URSL. The success rates of the first gravel, the rate of stone discharging 4 weeks after operation and the incidence of perioperative complications were evaluated. Results The success rate of primary gravel in group Ⅱ was 94.1%. The rate of gravel after 96 weeks was significantly higher than that of group Ⅰ 61.2% and 75.3% (P <0.05). Complications of fever, nausea / vomiting were found in both groups during the perioperative period, but there was no significant difference in the overall complication rate (P> 0.05). Conclusion URSL treatment of patients with lower ureteral calculi, high success rate of a gravel operation, more complete row of stone, and safety and security, as the future clinical treatment of ureteral calculi as a recommended surgical approach.