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目的观察输尿管镜钬激光碎石术(URSHL)与体外冲击波碎石术(ESWL)治疗小儿输尿管结石的临床疗效及安全性。方法 46例小儿输尿管结石患儿随机分为URSHL组26例和ESWL 20例,URSHL组采用URSHL治疗,ESWL组采用ESWL治疗。结果 URSHL组单次手术碎石成功率为94.7%(18/19),ESWL组为42.9%(3/7);而对照组在治疗输尿管上段结石的单次手术碎石成功率为84.6%(11/13)URSHL组为28.6%(2/7),两组比较,P<0.05;URSHL组手术平均时间、术后住院平均时间及术后结石清除率分别为(47.88±10.11)min、(3.42±0.95)d和92.4%,ESWL组分别为(60.25±12.08)min、(4.10±0.72)d和60.0%,两组比较,P<0.05;两组均无严重并发症发生。结论对于小儿输尿管中下段结石,URSHL临床疗效优于ESWL;而对于小儿输尿管上段结石,用ESWL治疗疗效更佳。
Objective To observe the clinical efficacy and safety of ureteroscopic holmium laser lithotripsy (URSHL) and extracorporeal shock wave lithotripsy (ESWL) in the treatment of ureteral calculi in children. Methods Forty-six children with ureteral calculi were randomly divided into URSHL group (n = 26) and ESWL (n = 20). URSHL group received URSHL and ESWL group received ESWL treatment. Results The success rate of single operation lithotripsy was 94.7% (18/19) in URSHL group and 42.9% (3/7) in ESWL group. The success rate of single operation lithotripsy in the control group was 84.6% (P <0.05). The average operation time, the average postoperative hospital stay and the postoperative stone clearance rate in URSHL group were (47.88 ± 10.11) min and ( 3.42 ± 0.95 d and 92.4%, respectively. The ESWL group was (60.25 ± 12.08) min, (4.10 ± 0.72) d and 60.0% respectively, P <0.05; no serious complication occurred in both groups. Conclusions The clinical efficacy of URSHL is superior to that of ESWL in children with lower ureteral calculi. ESWL is more effective in upper ureteral calculi in children.