Honeck P, Häcker A, Alken P, Michel M S, Knoll T
Department of Urology, Mannheim University Hospital, Theodor-Kutzer-Ufer 1-3, 68135, Mannheim, Germany.
Urol Res. 2006 Jun;34(3):190-2. doi: 10.1007/s00240-006-0041-9. Epub 2006 Jan 31.
We performed a prospective, non-randomised study to determine the appropriate first-line treatment modality for distal ureteral stones. Between 2003 and 2004, a total of 124 patients with distal ureteral calculi were entered into the study (mean age 48 years, 35 women and 99 men). Sixty-two patients were treated with shock wave lithotripsy (SWL) and 62 patients with ureteroscopy (URS). The average stone size was 6.9 mm (3-33 mm) for SWL and 7.2 mm (3-30 mm) for URS. The treatment decision depended on the patients' preference and clinical parameters (i.e. contraindications for anaesthesia). URS was performed under general anaesthesia, using semirigid 8 Fr instruments. SWL was performed under analgo-sedation using a Modulith SLX. Of patients treated with SWL, 84% had a treatment success within 7 days, 98% after URS. These results show a significant success (P=0.005) in favour of URS. The average in-patient stay after SWL was 3 days and for URS 4 days (not significant). The results show a high efficacy and a low complication rate for both modalities. The attained stone-free rate shows a significant advantage for primary URS.
我们进行了一项前瞻性、非随机研究，以确定输尿管下段结石合适的一线治疗方式。在2003年至2004年期间，共有124例输尿管下段结石患者纳入本研究（平均年龄48岁，女性35例，男性99例）。62例患者接受了冲击波碎石术（SWL），62例患者接受了输尿管镜检查（URS）。SWL组结石平均大小为6.9 mm（3 - 33 mm），URS组为7.2 mm（3 - 30 mm）。治疗决策取决于患者的偏好和临床参数（即麻醉禁忌证）。URS在全身麻醉下进行，使用半硬性8 Fr器械。SWL在镇痛镇静下使用Modulith SLX进行。接受SWL治疗的患者中，84%在7天内治疗成功，URS组为98%。这些结果显示URS具有显著优势（P = 0.005）。SWL后的平均住院时间为3天，URS为4天（无显著差异）。结果显示两种治疗方式均具有高疗效和低并发症发生率。首次URS获得的无石率显示出显著优势。
