输尿管镜下三种不同碎石方法治疗输尿管上段结石（长径≤1.0 cm）的效果对比

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摘要目的对比输尿管镜下三种不同碎石方法治疗输尿管上段结石（长径≤1.0 cm）的效果。方法选取2015年2月～2017年2月我院收治的169例输尿管上段结石（长径≤1.0 cm）患者作为研究对象，按照随机数字表分为A组（60例）、B组（52例）和C组（57例），A组采用超声碎石方法，B组采用输尿管镜下气压弹道碎石方法，C组采用钬激光碎石方法。比较三组的一次碎石成功率、结石排净率、术中出血量、术后住院时间、并发症发生率。结果A组和C组的一次碎石成功率高于B组，差异有统计学意义（P＜0.05），但A组和C组比较，差异无统计学意义（P＞0.05）；A组结石排净率高于B组和C组，差异有统计学意义（P＜0.05）；A组术中出血量少于B组和C组，差异有统计学意义（P＜0.05）；A组术后住院时间短于B组和C组，且B组长于C组，差异均有统计学意义（P＜0.05）；A组并发症的发生率低于B组和C组，差异有统计学意义（P＜0.05），B组与C组比较，差异无统计学意义（P＞0.05）。结论对输尿管上段结石（长径≤1.0 cm）患者建议采用输尿管镜下超声碎石治疗，一次碎石成功率高，出血量少，术后恢复快且并发症少，优势明显。

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	石崇军
	杨伟忠
	晏继银
	邓锦标
	张东江
	蔡华戈

关键词 ：输尿管镜, 气压弹道碎石, 超声碎石, 钬激光碎石, 输尿管上段结石

Abstract：Objective To compare the effectiveness of three different methods of lithotripsy under ureteroscope in treatment of ureteral calculi(length less than or equal to 1.0 cm).Methods From February 2015 to February 2017,169 cases of upper ureteral calculi(length less than or equal to 1.0 cm)treated in our hospital were selected as the research subjects,and divided into group A(60 cases),group B(52 cases)and group C(57 cases)according to a random table method.Group A was treated with ultrasonic lithotripsy,group B treated with ureteroscopic pneumatic ballistic lithotripsy,and group C was treated with holmium laser lithotripsy.The success rates,the rates of stone removal,the amount of bleeding in the operation,the time of postoperative hospitalization,and the incidences of complications of the three groups were compared.Results In group A and group C,the success rate of lithotripsy was higher than that in group B,the difference was statistically significant(P＜0.05),but there was no significant difference between group A and group C(P＞0.05).The rate of stone exclusion in group A was higher than that in group B and group C,the differences were statistically significant(P＜0.05).The amount of bleeding in group A was less than that in group B and group C,the differences were statistically significant (P＜0.05).The time of hospitalization in group A was shorter than group B and group C,the differences were statistically significant(P＜0.05).The incidence of complications in group A was lower than that in group B and group C,the differences were statistically significant (P＜0.05),and there was no statistical difference between group B and group C (P＞0.05).Conclusion The upper ureteral calculi(length less than or equal to 1.0 cm)patients treated with ureteroscopic lithotripsy in the treatment of ultrasound has high successful rate one time,with less bleeding,faster postoperative recovery and less complications and obvious advantages.

Key words： Ureteroscopy Ballistic lithotripsy Ultrasonic lithotripsy Holmium laser lithotripsy Upper ureteral calculi

作者简介: 石崇军（1980-），男，河北宣化人，硕士

引用本文:

石崇军;杨伟忠;晏继银;邓锦标;张东江;蔡华戈. 输尿管镜下三种不同碎石方法治疗输尿管上段结石（长径≤1.0 cm）的效果对比[J]. 中国当代医药, 2018, 25(10): 71-73转76.
SHI Chong-jun;YANG Wei-zhong;YAN Ji-yin;DENG Jin-biao;ZHANG Dong-jiang;CAI Hua-ge. Comparison ofthe three differentmethods oflithotripsy under ureteroscope in treatment of ureteral calculi(length less than or equal to 1.0 cm)the effect of contrast. 中国当代医药, 2018, 25(10): 71-73转76.

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