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目的探讨经输尿管镜钬激光碎石治疗输尿管结石的临床应用疗效。方法 120例输尿管结石患者,随机分为观察组和对照组,各60例。观察组进行经输尿管镜钬激光碎石术(LL)治疗,对照组进行体外冲击波碎石术(ESWL)治疗。比较两组患者的手术时间以及术后3个月结石排净率等指标。结果对照组患者治疗>1.0 cm与≤1.0 cm结石所需要的时间均比观察组长,差异具有统计学意义(P<0.05);结果显示,观察组术后3个月>1.0 cm结石排净率为90.63%,而对照组的结石排净率为64.71%,差异具有统计学意义(P<0.05);观察组患者输尿管中下段术后3个月结石排净率为93.75%,对照组结石排净率为67.65%,差异具有统计学意义(P<0.05)。结论两种方法均可以治疗输尿管结石,但是对于直径>1.0 cm或合并有输尿管狭窄、息肉的输尿管结石,尤其是中下段输尿管结石患者,作者建议首选的治疗方案为LL治疗。而对于直径≤1.0 cm的输尿管结石,特别是输尿管上段结石患者,作者建议可以考虑采用ESWL。
Objective To investigate the clinical efficacy of ureteroscopic holmium laser lithotripsy in the treatment of ureteral calculi. Methods 120 patients with ureteral calculi were randomly divided into observation group and control group, each 60 cases. The observation group was treated by ureteroscopic holmium laser lithotripsy (LL), while the control group was treated by extracorporeal shock wave lithotripsy (ESWL). The operation time of two groups of patients and the indexes of stone clearance rate after 3 months were compared. Results The time required for the treatment of stones> 1.0 cm and ≤1.0 cm in the control group was significantly longer than that of the control group (P <0.05). The results showed that the stones in the observation group had a net discharge of 1.0 cm at 3 months The rate of stones was 90.63% in the control group (64.71%), the difference was statistically significant (P <0.05). The stones removal rate in the middle and lower ureter of the observation group was 93.75% at 3 months after operation, The net discharge rate was 67.65%, the difference was statistically significant (P <0.05). Conclusion Both methods can treat ureteral calculi, but for patients with ureteral stones> 1.0 cm in diameter or with ureteral strictures and polyps, especially those with lower and middle ureteral calculi, the authors suggest that the preferred treatment is LL. For ureteral stones ≤1.0 cm in diameter, especially in patients with upper ureteral stones, the authors suggest that ESWL may be considered.