高杰陶 古嘉媚 申囡

[摘要]目的 观察经输尿管镜气压弹道碎石治疗输尿管结石的临床效果。方法 回顾性分析我院2015年1月～2017年1月收治入院的200例行输尿管结石术患者的临床资料，根据治疗方法不同分为观察组和对照组，各100例。观察组采用经输尿管镜气压弹道碎石治疗，对照组采用体外冲击波碎石术。评估观察两组患者治疗中的一次性碎石成功率、治疗满意度、手术时间、住院时间及并发症等情况。结果 观察组的手术时间、住院时间均明显短于对照组，差异有统计学意义（P<0.05）。观察组的一次性碎石成功率、满意度等指标均显著高于对照组，差异有统计学意义（P<0.05）。观察组的并发症总发生率为10.0%，低于对照组的27.0%，差异有统计学意义（P<0.05）。结论 经输尿管镜气压弹道碎石治疗输尿管结石安全、有效，结石清除率高，操作时间短，值得临床应用。

[关键词]输尿管镜；气压弹道碎石；输尿管结石

[中图分类号] R693+.4 [文献标识码] A [文章编号] 1674-4721（2018）7（c）-0070-03

[Abstract] Objective To observe the clinical efficacy of pneumatic lithotripsy in the treatment of ureteral calculi under ureteroscope. Methods The clinical data of 200 patients undergoing ureteral calculi admitted to our hospital from January 2015 to January 2017 were retrospectively analyzed. The data were divided into the observation group and the control group according to different treatment methods. Patients in the observation group were performed with ureteroscopic pneumatic lithotripsy， and patients in the control group were treated with extracorporeal shock wave lithotripsy. The success rate of lithotripsy for once， treatment satisfaction， operation time， hospital stay， and complications during treatment were evaluated and compared in the two groups. Results In the observation group， the operation time and hospital stay were both shorter compared with those in the control group with statistical differences （P<0.05）. The success rate of lithotripsy for once and satisfaction in the observation group were both higher than those in the control group with significant differences （P<0.05）. The total incidence of complications in the observation group was 10.0%，which was lower than 27.0% in the control group with statistical significance （P<0.05）. Conclusion Pneumatic lithotripsy is safe and effective in the treatment of ureteral calculi， with high stone clearance rate and short operation time， which is worthy of clinical application.

[Key words] Ureteroscope； Pneumatic lithotripsy； Ureteral calculi

輸尿管结石是泌尿外科常见病之一，发生率在泌尿外科住院患者中常占居首位。由于技术的进步，体外冲击波碎石术与输尿管镜技术在临床中逐步得到推广，从而让输尿管结石可以不通过开放性手术治疗，而开放性手术的使用率仅仅为5%左右[1]。输尿管镜下气压弹道碎石手术方法具有安全、时间短、无热效应、对周围组织不造成损伤、碎石效果可靠及治疗费用低廉等优点[2]，为广大患者所接受，并广泛开展。本研究选取我院诊治的输尿管结石患者，分析体外冲击波碎石术与输尿管镜气压弹道碎石的效果差异，现报道如下。

1资料与方法

1.1一般资料

随机抽取我院2015年1月～2017年1月的200例输尿管结石患者，根据治疗方法不同分为对照组与观察组，各100例。对照组中，男61例，女39例；年龄为28～73岁，平均（41.5±4.9）岁；结石位置：输尿管上段者19例，中段者34例，下段者47例；……