大型近端输尿管结石的治疗：体外冲击波碎石术与配备碎石器的半硬性输尿管镜的对比
Treatment of large proximal ureteral stones: extra corporeal shock wave lithotripsy versus semi-rigid ureteroscope with lithoclast.
作者信息
Tawfick Ehab R
机构信息
Urologu Department, El-Minia University, El-Mehata Street (Borg Savoy), El-Minia City, Posta Code 61111, Country Egypt.
出版信息
Int Arch Med. 2010 Jan 28;3:3. doi: 10.1186/1755-7682-3-3.
PURPOSE
Assessment of safety and efficacy of extracorporeal shockwave lithotripsy versus semi-rigid ureteroscope with lithoclast for treatment of large proximal ureteral stones.
MATERIALS AND METHODS
The study included 147 patients with large upper ureteral stones. SWL and ureteroscopy were performed in 71 and 76 patients respectively. Patients in the SWL group were treated with Siemens: - Modularis lithovario under intravenous sedation on an out patient basis. Patients in the ureteroscopy group were treated with (7.5 Fr) semi-rigid ureteroscope and lithoclast under spinal anesthesia on a day care basis.
RESULTS
Stone - free rate for in situ SWL was 58% (41 of 71) patients. For semi-rigid ureteroscope accessibility of the stones was 94% (72 of 76) and the stone free rate was 92% (70 of 76) No major complications were encountered in both groups.Mean stone size was 1.34 +/- 0.03 cm in the SWL group and 1.51 +/- 0.04 in the ureteroscopy group.
CONCLUSIONS
Our study demonstrates that ureteroscopy with lithoclast can be considered as acceptable treatment modality for large proximal ureteral calculi and can be considered as fist line for treatment of large proximal ureteral stones.
目的
评估体外冲击波碎石术与使用碎石器的半硬性输尿管镜治疗近端输尿管大结石的安全性和有效性。
材料与方法
该研究纳入了147例近端输尿管大结石患者。分别对71例和76例患者进行了体外冲击波碎石术（SWL）和输尿管镜检查。SWL组患者在门诊接受静脉镇静下的西门子Modularis lithovario治疗。输尿管镜检查组患者在日间手术基础上接受脊髓麻醉下的（7.5 Fr）半硬性输尿管镜和碎石器治疗。
结果
原位SWL的结石清除率为58%（71例中的41例）。对于半硬性输尿管镜，结石可及率为94%（76例中的72例），结石清除率为92%（76例中的70例）。两组均未出现重大并发症。SWL组结石平均大小为1.34±0.03 cm，输尿管镜检查组为1.51±0.04 cm。
结论
我们的研究表明，使用碎石器的输尿管镜检查可被视为治疗近端输尿管大结石的可接受治疗方式，可被视为治疗近端输尿管大结石的一线治疗方法。
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