钬激光与气压弹道碎石术治疗输尿管结石的临床比较

The therapeutic effect comparison of holmium laser lithotripsy and pneumatic lithotripsy for ureterolith

摘要:

目的 比较输尿管镜下钬激光碎石术（HL）与气压弹道碎石术（PL）治疗输尿管结石的疗效与安全性。 方法 回顾性分析输尿管镜下治疗214例输尿管结石患者的临床资料，其中采用钬激光碎石治疗146例，气压弹道碎石治疗68例。 结果 HL组单次手术碎石率95.21%，中下段结石为96.69%，上段结石为88.00%；PL组单次手术碎石率88.24%，中下段结石为91.94%，上段结石为81.25%。HL组平均碎石与取石时间10 min，PL组为17 min。术后1个月HL组结石排尽率98.63%，HL组为92.65%。 结论 HL及PL是治疗输尿管结石安全及有效的方法，但HL较PL效率更高，尤其是合并输尿管息肉、输尿管狭窄或者输尿管上段结石的病例，值得临床推广应用。

Abstract:

【Objective】 To compare the therapeutic effect of holmium laser lithotripsy (HL) and pneumatic lithotripsy (PL) in the treatment of ureterolith. 【Methods】 The clinical data of HL (146 cases) and PL (68 cases) were investigated and compared with statistical analysis. 【Results】 The success rate in single lithotripsy reached 95.21% in HL and 88.24% in PL (P <0.05). It reached 96.69% in HL and 91.94% in PL for lower ureteral calculi (P <0.05). It reached 88.00% in HL and 81.25% in PL for upper ureteral calculi (P <0.05). The average operation time of HL was 10 minutes and 17 minutes in PL (P <0.05). After one month of follow-up, the stone drain rate reached 98.63% in HL and 92.65% in PL (P <0.05). 【Conclusion】 Ureteroscopic holmium laser lithotripsy and ureteroscopic pneumatic lithotripsy are both good for ureterolith. However, holmium laser lithotripsy has greater advantages than pneumatic lithotripsy in success rate and stone drain rate, especially when dealing with inflammatory, ureterostenoma or upper ureteral calculi.