经输尿管硬镜钬激光碎石术与气压弹道碎石术治疗输尿管多发结石的临床研究

Ureteroscopy with Holmium laser lithotripsy or pneumatic ballistic lithotripsy in patients with multiple ureteral calculi

摘要:

目的 比较钬激光碎石术与气压弹道碎石术治疗单侧输尿管多发结石的临床效果和安全性。 方法 选择2008年11月-2014年12月该院收治的单侧输尿管多发结石患者45例，随机分为两组，钬激光组23例，气压弹道组22例。钬激光组采用输尿管镜下钬激光碎石术治疗，气压弹道组采用气压弹道碎石术治疗，比较两组患者的治疗效果和临床安全性。结果 钬激光组手术时间为（57.6±9.3）min，住院时间为（2.3±1.1）d；气压弹道组手术时间为（68.0±11.7）min，住院时间为（3.6±1.5）d，两组比较差异有统计学意义（P <0.05）。两组的碎石成功率、碎石总有效率均为100.00%。两组的结石排净率、术后并发症发生率差异无统计学意义（P >0.05）。结论 钬激光与气压弹道均可用于治疗单侧输尿管多发结石，钬激光碎石术更具有优势，值得临床推广应用。

Abstract:

Objective To compare the clinical effects and safety of ureteroscopy with holmium laser lithotripsy and pneumatic ballistic lithotripsy in the patients who underwent multiple ureteral calculi. Methods From Nov. 2008 to Dec. 2014, we enrolled 45 patients who were admitted and diagnosed as multiple ureteral calculi. They were randomly divided into two groups, that is, the observation group: 23 patients who accepted ureteroscopy with holmium laser lithotripsy, and the control group: 22 patients who were given ureteroscopy with pneumatic ballistic lithotripsy. The clinical effects and safety between the two groups were compared. Results The operation time is (57.6 ± 9.3) min, and the hospitalization time is (2.3 ± 1.1) d in holmium laser lithotripsy group; and (68.0 ± 11.7) min and (3.6 ± 1.5) d in pneumatic ballistic lithotripsy group; The difference between the two groups was statistically significant (P < 0.05). The success rate of lithotripsy and the total effective rate of lithotripsy of both groups are all 100.00%. There is no difference of the lithagogue rate and the postoperative complications between the two groups (P > 0.05). Conclusions The overall effect of Holmium laser lithotripsy and Pneumatic ballistic lithotripsy for patients with Multiple ureteral calculi, were similar. Based on the operation time and hospitalization time, Holmium laser lithotripsy is superior to Pneumatic ballistic lithotripsy, and it deserves to be popularized and employed in clinical practice.