U-100双频激光和气压弹道两种碎石术治疗输尿管结石比较

目的:比较U-100双频激光碎石术与气压弹道碎石术治疗输尿管结石的疗效和实用性.方法:采用U-100双频激光碎石术治疗输尿管结石498例,气压弹道碎石术342例.比较两组手术时间、单次手术碎石率、结石排净时间、手术并发症的差异.结果:U-100双频激光碎石术手术时间为29.8±5.4 min,少于气压弹道碎石术44.3±9.5min,P<0.05;U-100双频激光碎石术(U-100组)单次手术输尿管结石碎石率为93.2%(464/498),高于气压弹道碎石术(PL组)的79.8%(273/342),P<0.05;U-100组的结石排净时间为18.5±4.4d,短于PL组的31.2±5.8d,P<0.05;U-100组并发症相对较少,无一例发生输尿管穿孔;而PL组9例发生输尿管穿孔.结论:U-100双频激光碎石术的疗效和实用性明显优于气压弹道碎石术.

Comparative Study of Frequency-doubled-double-pulse Laser Lithotripsy with Pneumatic Ballistic Lithotripsy for Ureteral Calculi

To compare the efficacy and practicability of ureteroscopic frequency-doubled-double-pulse laser lithotripsy(U-100) with ureteroscopic pneumatic ballistic lithotripsy(PL) for ureteral calculi. Methods:The 498 patients underwent ureteroscopy with frequency-doubled-double-pulse laser lithotripsy;the 342 patients underwent ureteroscopy with pneumatic ballistic lithotripsy. The operation duration,stone-free rate of first lithotripsy,stone-free time and complication were compared between the 2 groups. Results:The mean operation duration of ureteroscopy with frequency-doubled-double-pulse laser lithotripsy for ureteral calculi was shorter than that with ureteroscopic pneumatic ballistic lithotripsy(29.8±5.4minVS 44.3±9.5min,P<0.05).In U-100 group,93.2% of patients were successful on the first lithotripsy.which was higher than that of PL(93.2%VS79.8%,P<0.05).The stone-free time of U-100 was shorter than that of PL (18.5±4.4daysVS31.2±5.8days,P<0.05).No major complication was observed in U-100 group whereas 9 perforations were encountered in PL. Conclusions:Ureteroscopic frequency-doubled-double-pulse laser lithotripsy for ureteral calculi is more effective and practical than ureteroscopic pneumatic ballistic lithotripsy.