陈忠铭 杨政兴 张梁 刘美宝

【摘要】 目的：对比钬激光碎石术与体外冲击波碎石术对输尿管结石的治疗效果。方法：选取966例于2015年2月-2018年2月入住笔者所在医院的输尿管结石患者为研究对象，随机分为对照组和观察组。对照组用体外冲击波碎石术，予以观察组钬激光碎石术，进行两组治疗成效的对比。结果：观察组手术时间长于对照组，但术后排石时间明显短于对照组，差异有统计学意义（P<0.05）;观察组对直径<1 cm的结石排净率高于对照组，直径≥1 cm的结石排净率低于对照组，差异均有统计学意义（P<0.05）;观察组出现并发症的概率为5.80%，与对照组的9.32%相比，差异有统计学意义（P<0.05）。结论：与体外冲击波碎石术相比，钬激光碎石术可提高输尿管结石排净率，缩短结石外排时间，降低并发症发生风险，但前者在清除较大结石方面存在优势，需结合患者病情选择合适的手术方式。

【关键词】 输尿管结石 钬激光碎石术 体外冲击波碎石术

doi：10.14033/j.cnki.cfmr.2019.29.065 文獻标识码 B 文章编号 1674-6805（2019）29-0-03

[Abstract] Objective： To compare the therapeutic effects of Holmium laser lithotripsy and extracorporeal shock wave lithotripsy on ureteral calculi. Method： A total of 966 patients with ureteral calculi admitted to the hospital from February 2015 to February 2018 were enrolled in the study. They were randomly divided into the control group and the observation group. In the control group， extracorporeal shock wave lithotripsy was used to observe the holmium laser lithotripsy in the observation group. Result： The operation time of the observation group was longer than that of the control group， but the time of stone removal was significantly shorter than that of the control group （P<0.05）. The observation rate of the stone with diameter <1 cm was higher than that of the control group. The sputum discharge rate of ≥1 cm in diameter was lower than that of the control group， and the differences were statistically significant （P<0.05）. The probability of complications in the observation group was 5.80%， compared with 9.32% of the control group. The difference was statistically significant （P<0.05）. Conclusion： Compared with extracorporeal shock wave lithotripsy， Holmium laser lithotripsy can improve the clearance rate of ureteral calculi， shorten the time of stone efflux and reduce the risk of complications. However， the former has advantages in clearing larger stones， so it is necessary to select appropriate surgical methods according to the patients condition.

[Key words] Ureteral calculi Holmium laser lithotripsy Extracorporeal shock wave lithotripsy

First-authors address： Fuzhou Second Hospital Affiliated to Xiamen University， Fuzhou 350000， China

输尿管结石在临床上较为常见，以中壮年群体为主要发病对象，男性发病率高于女性，临床症状以尿频、尿急、尿痛、寒战、发热为主，合并梗阻时可有肾功能不全症状，部分患者可有胃肠道不适、贫血症状，对患者正常生活有着严重影响[1]。外科手术方式是治疗此病的有效措施，在清除结石、控制疾病发展进程方面起着重要作用[2]。为深入探讨治疗输尿管结石的有效措施，笔者所在医院予以收治的部分患者体外冲击波碎石术和钬激光碎石术，现将研究详情总结报道如下。

1 资料与方法

1.1 一般资料

从笔者所在医院2015年2月-2018年2月收治的输尿管结石患者中随机选取966例为研究对象，纳入标准：（1）临床症状符合文献[3]输尿管结石诊断标准;（2）年龄：20～80岁;（3）无体外冲击波碎石术和钬激光碎石术禁忌证。排除标准：（1）重要脏器功能受损严重者（2）正在接受其他治疗或近期有过其他治疗;（3）存在其他类型结石病变;（4）精神病患者或存在认知障碍。……