冲击波碎石术与输尿管镜取石术治疗输尿管中下段结石的临床研究

摘要

目的 比较研究冲击波碎石与输尿管镜取石术治疗输尿管中下段结石的临床疗效和安全性.方法 苏州市市立医院北区泌尿外科以2010年7月至2012年7月期间收治的70例行输尿管下段结石患者为研究对象.70例患者随机分为两组(n=35),分别于行冲击波碎石或输尿管镜取石术.采用平衡计分方法对体外冲击波碎石和输尿管镜取石术进行综合比较.结果 URL和SWL清除结石的总有效率相当,疗效上URL略优于SWL,但差异无统计学意义(P>0.05)；SWL组的手术操作时间显著短于URL组(P<0.05)；SWL组的住院时间和经济费用低于URL组；SWL组的术后并发症发生率低于URL组.结论 体外冲击波碎石术显著优于输尿管取石术,是治疗输尿管中下段结石的首选方法,而输尿管取石术可有益弥补体外冲击波碎石术的不足.%　　Objective  To investigate and compare the shock-wave lithotripsy and ureteroscopic lithotripsy on the therapy of urinary calculi in the middle and inferior ureter. Method  70 patients with urinary calculi in the middle and inferior ureter in Suzhou municipal hospital during a period from July 2010 to July 2012 were randomized into two groups at 35 patients per group, SWL group and URL group. Patients in SWL group were treated shock-wave lithotripsy and patients in URL group were treated with ureteroscopic lithotripsy. The therapy efficiency was finally evaluated by balance scoring method. Results  No significant differences in efficacy was observed for both URL and SWL (P<0.05); however, it was observed that operation time, recovery time, cost, and complication rate in SWL group were lower or shorter than those in URL group. Conclusion  It is concluded that SWL is a preferred therapy for urinary calculi in the middle and inferior ureter and URL may serve as complementary approach for SWL.