目的：评估预置输尿管支架管对于体外冲击波碎石（ESWL）治疗上尿路非梗阻性结石的疗效及安全性。方法选取2010年1月至2013年1月于重庆骑士医院外一科接受ESWL治疗且符合纳入排除标准的非梗阻性输尿管上段或肾结石患者96例。分成两组，A组直接行ESWL ，B组预置输尿管支架管后行ESWL ，1个月后评价碎石效果及拔出输尿管支架管，2个月后再次评价碎石效果。结果术后1个月时A组患者结石清除率明显高于B组（P＝0．02），术后2个月时B组明显高于A组（P＝0．001），差异有统计学意义；A组患者肾绞痛发生率明显高于B组（ P＝0．001）、B组患者肉眼血尿发生率明显高于 A组（ P＝0．005），差异有统计学意义；两组患者在术后感染、形成石街、下尿路症状的发生率比较差异无统计学意义（ P＞0．05）。结论对于小于2．0 cm的非梗阻性肾结石和小于1．0 cm的输尿管上段结石，预置输尿管支架管后再行ESWL能有效增加一次性碎石的结石清除率，排石主要发生在拔出支架管后，同时能有效降低肾绞痛的发生率而不会引发严重的下尿路症状，但可能会增加肉眼血尿的发生。%Objective To assess the efficacy and safety of stenting ureteral stent prior to extracorporeal shock wave lithotrip‐sy(ESWL) for non‐obstructive upper ureter and renal stone .Methods From January 2012 to October 2013 ,a total of 96 patients who met inclusion and exclusion criteria were randomly devided into two groups :a stented group (group B) with a double‐J ureter stent fixed pre‐ESWL and a non‐stented group (group A) treated with ESWL direactly .Outcomes were evaluated in 1 month and then the ureter stent was removed ,another evaluation was taken after 2 months .Results The clearance rate in group A was signifi‐cant higher than that of group B at first month(P=0 .02) ,but group B was significant higher than that of group A at the second month(P=0 .001) .The renal colic rate of group A was significant higher than that of group B(P=0 .001) ,the gross hematuria rate of group B was significant higher than that of group A(P=0 .005) .The comparison of fever ,steinstrasse ,lower urinary tract syn‐drome showed no statistical difference(P>0 .05) .Conclusion Stenting ureter stent may increase the clearance rate of ESWL by 1 session for non‐obstructive upper ureter and renal stone ,but the passage of stones mainly happen after the removing of stent .Stent‐ing can also prevent the morbidity of renal colic without increasing low urinary tract syndrome ,but can increase the morbidity of gross hematuira .
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