输尿管镜下激光碎石术与气压弹道碎石术治疗输尿管结石的前瞻性对照研究。

Ureteroscopic laser lithotripsy versus ballistic lithotripsy for treatment of ureteric stones: a prospective comparative study.

作者信息

Garg S, Mandal A K, Singh S K, Naveen A, Ravimohan M, Aggarwal M, Mete U K, Santosh K

机构信息

Department of Urology, Postgraduate Institute of Medical Education and Research, Chandigarh, India.

出版信息

Urol Int. 2009;82(3):341-5. doi: 10.1159/000209369. Epub 2009 May 11.

DOI:10.1159/000209369

PMID:19440025

Abstract

OBJECTIVES

This study was undertaken to compare the results of laser (Ho:YAG) and pneumatic (ballistic) intracorporeal lithotripsy for ureteric calculi in terms of efficacy, safety and complications.

METHODS

55 patients having ureteric calculus were randomly allocated into pneumatic lithotripsy (PL) and laser lithotripsy (LL) groups. Swiss lithoclast was used for PL (3 atm pressure and 12 Hz frequency) and the VersaPulse PowerSuite was used for LL. Appropriate statistical tests were applied.

RESULTS

30 patients (34 stones) were treated with LL and 25 patients (25 stones) with PL. Both groups were comparable in profile. Mean lithotripsy time was 24.03 +/- 9.51 min in the LL group and 19.80 +/- 4.44 min in the PL group (p = 0.027). The immediate stone clearance rate was higher in the LL group (p = 0.001), but it was comparable at 4 weeks (p = 0.097). Stone migration occurred in 16% of cases in the PL group. No major complication was observed in either group.

CONCLUSIONS

We conclude that both laser and pneumatic energies are effective and safe for intracorporeal lithotripsy. Laser lithotripsy takes more time but provides earlier stone-free status.

摘要

目的

本研究旨在比较激光（钬激光）和气压弹道体内碎石术治疗输尿管结石在疗效、安全性及并发症方面的结果。

方法

55例输尿管结石患者被随机分为气压弹道碎石术（PL）组和激光碎石术（LL）组。气压弹道碎石术采用瑞士碎石机（压力3个大气压，频率12赫兹），激光碎石术采用VersaPulse PowerSuite。应用了适当的统计学检验。

结果

30例患者（34枚结石）接受了激光碎石术治疗，25例患者（25枚结石）接受了气压弹道碎石术治疗。两组在资料方面具有可比性。激光碎石术组的平均碎石时间为24.03±9.51分钟，气压弹道碎石术组为19.80±4.44分钟（p = 0.027）。激光碎石术组的即刻结石清除率更高（p = 0.001），但在4周时两组相当（p = 0.097）。气压弹道碎石术组有16%的病例发生结石移位。两组均未观察到严重并发症。