标题：钬激光碎石术与体外冲击波碎石术治疗输尿管结石的疗效及安全性探讨

      作者：陈 康，窦红珍，陈先平
    (阆中市人民医院泌尿外科，四川 阆中 637400)

      卷次： 2015年26卷14期

      【摘要】 目的 探讨钬激光碎石术(LL)与体外冲击波碎石术(ESWL)治疗输尿管结石的疗效及安全性。
方法 选择 2012年 6月至 2014年 6月在我院接受治疗的输尿管结石患者 136例作为研究对象。根据数字法随
机分成LL组及ESWL组各68例，LL组采用LL术式治疗，ESWL组采用ESWL术式治疗，随访1个月，比较两组
患者的治疗效果、手术时间、结石排净率和不良反应，分析结石直径大小与手术时间及1个月结石排净率的相关
性。结果 LL组各分段的碎石成功率及总成功率均明显高于对照组，差异均有统计学意义(P<0.05)。结石直径
≥1 cm时，LL组的手术时间明显少于ESWL组，1个月结石排净率明显大于ESWL组，差异均有统计学意义(P<
0.05)。结石直径<1 cm时，LL组的手术时间明显少于ESWL组，但两组1个月结石排净率比较差异无统计学意义
(P>0.05)。LL组的总并发症发生率明显低于ESWL组，差异有统计学意义(P<0.05)。根据Pearson法分析相关性
可知，随着结石直径增大，两组手术时间逐渐增大，呈正相关(r=0.821)；而 1月结石排净率逐渐减小，呈负相关
(r=-0.769)。结论 LL术式对输尿管结石的疗效较好，安全性较高，但当结石直径小于1 cm时，因ESWL具有无
需麻醉等特点应以ESWL术式为首选方案。

      【关键词】 钬激光碎石术；体外冲击波碎石术；输尿管结石；疗效；安全性

      【中图分类号】 R693+.4 【文献标识码】 A 【文章编号】 1003—6350（2015）14—2066—03


Safety and efficacy of holmium laser lithotripsy and extracorporeal shock wave lithotripsy in the treatment of
ureteral calculi.
CHEN Kang, DOU Hong-zhen, CHEN Xian-ping. Department of Urinary Surgery, Langzhong People's
Hospital, Langzhong 637400, Sichuan, CHINA

【Abstract】 Objective To study the safety and efficacy of holmium laser lithotripsy (LL) and extracorpore-
al shock wave lithotripsy (ESWL) in the treatment of ureteral calculi. Methods One hundred and thirty-six patients
of ureteral calcul treated in our hospital from June 2012 to June 2014 were selected as research objects. The patients
were randomly divided into LL group and ESWL group with 68 cases in each group, based on random number table.
LL group applied LL for treatment, and ESWL group used ESWL operation for treatment. After 1 month of fol-
low-up, the clinical efficacy, operation time, lithagogue rate, and adverse reactions were compared between the two
groups. The correlations between the diameter of stones size, operation time and 1-month lithagogue rate were ana-
lyzed. Results In LL group, the segmental success rate of lithotripsy and the total success rate were significantly
higher than those in the control group, and the differences were statistically significant (P<0.05). When the diameter of
the stone was no less than 1 cm, the operation time in LL group was significantly less than that in ESWL group, and
the 1-month lithagogue rate was significantly higher than that of ESWL group, with statistically significant differenc-
es (P<0.05). When the diameter of the stone was less than 1 cm, the operation time in LL group was significantly less
than that in ESWL group, but the 1-month lithagogue rate showed no significant difference between the two groups
(P>0.05). The total incidence of complications in LL group was significantly lower than that in ESWL group, and the
difference was statistically significant (P<0.05). According to Pearson correlation analysis, with the increase of the
stone diameter, the operation time of the two groups in increased (showing a positive correlation, r=0.821), and
1-month lithagogue rate gradually decreased (showing a negative correlation, r=-0.769). Conclusion Compared
with ESWL, LL has results in better efficacy and higher safety in the treatment of ureteral calculi. However, when the
stone diameter is less than 1 cm, ESWL should be the preferred scheme for no need of anesthesia.

      【Key words】 Holmium laser lithotripsy; Extracorporeal shock wave lithotripsy; Ureteral calculi; Efficacy;
Safety