Zeng Guang-Qiao, Zhong Wei-De, Cai Yue-Bin, Dai Qi-Shan, Hu Jian-Bo, Wei Hong-Ai
Department of Urology, First Municipal People's Hospital, Guangzhou 510180, China.
Asian J Androl. 2002 Dec;4(4):303-5.
To compare the efficacy and complications of extracorporeal shock-wave lithotripsy (SWL) and pneumatic ureteroscopic lithotripsy (URS) in the treatment of lower ureteral calculi.
From August 1997 to June 1999, 210 patients with calculi in the distal third of the ureter were treated with SWL and the other 180 with URS. The stones were fragmented with either HB-ESWL-V lithotripter or JML-93 pneumatic lithotripter through Wolf 7.5 approximately 9.0 Fr ureteroscope. The outcome was assessed in terms of stone clearance rate, re-treatment rate and complication incidence.
The stone clearance rate was 78.1 % with SWL and 93.3 % with URS (P<0.05). SWL had a re-treatment rate of 11.9 %, vs 2.2 % in the URS group (P<0.05). URS caused ureteral perforation in 3.3% of patients, while it was 0 with SWL (P<0.05). The differences in the incidence of other complications such as infection and stricture between the two groups were insignificant.
Though the selection of these two options depends on equipments available and the expertise of the operator, we recommend URS as the optimal treatment for distal ureteral calculi.
比较体外冲击波碎石术（SWL）和气压弹道输尿管镜碎石术（URS）治疗输尿管下段结石的疗效及并发症。
1997年8月至1999年6月，210例输尿管下段三分之一处结石患者接受了SWL治疗，另外180例接受了URS治疗。结石通过HB-ESWL-V碎石机或JML-93气压弹道碎石机经Wolf 7.5至9.0 Fr输尿管镜进行粉碎。根据结石清除率、再次治疗率和并发症发生率评估疗效。
SWL的结石清除率为78.1%，URS为93.3%（P<0.05）。SWL的再次治疗率为11.9%，URS组为2.2%（P<0.05）。URS导致3.3%的患者输尿管穿孔，而SWL为0（P<0.05）。两组间感染和狭窄等其他并发症发生率的差异无统计学意义。
虽然选择这两种方法取决于可用设备和操作者的专业技能，但我们推荐URS作为输尿管下段结石的最佳治疗方法。
