CAJ | 학술논문

目的比较急诊输尿管镜下气压弹道碎石术(ureteroscopic lithotripsy,URSL)与体外冲击波碎石术(extracorporeal shock wave lithotripsy,ESWL)治疗输尿管中下段结石并急性肾绞痛的疗效.方法回顾性分析本院近3年来45例急诊URSL(URSL组)以及51例急诊ESWL(ESWL组)治疗输尿管中下段结石并急性肾绞痛患者的临床资料,比较其疼痛缓解率、一次性碎石成功率、术后2周结石排净率、并发症发生率等指标.结果 URSL组和ESWL组疼痛缓解率分别为95.56％(43/45)和78.43％(40/51)(P＜0.05),URSL组一次性碎石成功率和术后2周碎石排净率分别为93.33％ (42/45)、97.78％ (44/45),明显优于ES-WL组的78.43％ (40/51)、82.35％(42/51)(P＜0.05);URSL组术后有2例发生尿路感染,ESWL组术后有4例发生肉眼血尿,两组术后均未出现发热、输尿管穿孔、撕裂等并发症(P＞0.05).结论对于结石直径＞l0mm的输尿管中下段结石并急性肾绞痛患者,急诊输尿管镜术疗效优于体外冲击波碎石术;首选输尿管镜术治疗此类患者具备一定的临床推广价值.
목적 비교급진수뇨관경하기압탄도쇄석술(ureteroscopic lithotripsy,URSL)여체외충격파쇄석술(extracorporeal shock wave lithotripsy,ESWL)치료수뇨관중하단결석병급성신교통적료효.방법 회고성분석본원근3년래45례급진URSL(URSL조)이급51례급진ESWL(ESWL조)치료수뇨관중하단결석병급성신교통환자적림상자료,비교기동통완해솔、일차성쇄석성공솔、술후2주결석배정솔、병발증발생솔등지표.결과 URSL조화ESWL조동통완해솔분별위95.56％(43/45)화78.43％(40/51)(P＜0.05),URSL조일차성쇄석성공솔화술후2주쇄석배정솔분별위93.33％ (42/45)、97.78％ (44/45),명현우우ES-WL조적78.43％ (40/51)、82.35％(42/51)(P＜0.05);URSL조술후유2례발생뇨로감염,ESWL조술후유4례발생육안혈뇨,량조술후균미출현발열、수뇨관천공、시렬등병발증(P＞0.05).결론 대우결석직경＞l0mm적수뇨관중하단결석병급성신교통환자,급진수뇨관경술료효우우체외충격파쇄석술;수선수뇨관경술치료차류환자구비일정적림상추엄개치.
Objectives To compare the efficacy and complication of emergency ureteroscopy lithotripsy(URSL) and extracorporeal shock wave lithotripsy(ESWL) in management of middle or lower ureteral calculi with a-cute renal colic.Methods 45 cases with middle or lower ureteral calculi were treated with emergency URSL(URSL group) and 51 cases with middle or lower ureteral calculi were treated with ESWL (ESWL group).Clinicaldata of two groups,which came from our hospital the last three years,were analyzed retrospectively.To compare thesuccess rate of lithotripsy,pain release,clearance rate of stones after two weeks and complication incidence of the twogroups.Results The success rates of postoperative pain release,disposable lithotripsy,clearance of stones aftertwo weeks in URSL group were higher than that in ESWL group (95.56％ vs 78.43％,93.33％ vs 78.43％,97.78％ vs 82.35％,respectively,P ＜ 0.05).2 urinary tract infections were encountered in URSL group whereas 4 ca-ses in ESWL group suffered from macroscopic haematuria.There is no significant statistical difference between twogroups in complication,such asmacroscopic haematuria,ureter perforation,ureter tear,fever,urinary tract infectionand so on(P ＞ 0.05).Conclusions URSL is the better choice than ESWL for middle or lower ureteral calculiwith acute renal colic.so preferred ureteroscopy surgery has a certain clinical value of popularization in managementof those stones,which are longer than 10 mm in their diameter.