经腹侧与经背侧超声定位在输尿管上段结石体外冲击波碎石术治疗中的效果比较

doi:10.3969/j.issn.10056483.2019.02.013

摘要/Abstract

摘要： 目的：分析经腹侧与经背侧超声定位在输尿管上段结石体外冲击波碎石术（ESWL）治疗中的疗效差异。方法：行ESWL治疗的输尿管上段结石病人260例，随机分为两组，每组130例，经腹侧超声定位为观察组，经背侧超声定位为对照组，比较两组病人超声定位情况、治疗效果及术后并发症情况的差异。结果：观察组超声探查结石距皮肤距离（3.8±1.3）cm，对照组的（8.2±2.4）cm，两组比较差异有统计学意义（P＜0.05）；观察组结石定位时间（5.2±2.4）分钟，对照组（12.1±3.2）分钟，两组比较差异有统计学意义（P＜0.05）；观察组结石一次清除率90.0%，对照组80.0%，观察组二次治疗率10%，三次治疗率0，对照组分别是20.0%和7.7%，两组比较差异有统计学意义（P＜0.05）；两组病人术后血尿次数、肾血肿发生率及泌尿感染发生率比较差异无统计学意义（P>0.05）。结论：经腹侧超声定位较传统背侧定位更加准确，有利于进一步提高输尿管上段结石体ESWL疗效，安全性高。

关键词: 超声定位, 体外冲击波碎石术, 输尿管上段结石, 疗效

Abstract: Objective：To analyze the difference in the efficacy of extracorporeal shock wave lithotripsy（ESWL） in the treatment of upper ureteral calculi by transthoracic and dorsal ultrasound.Methods：260 patients with upper ureteral stones treated with ESWL were randomly divided into two groups.The ventral ultrasound was used as the observation group，and the dorsal ultrasound was used as the control group.Ultrasound positioning，therapeutic effect，differences in postcomplications were compared between the two groups.Results：The distance between the observation group and the skin was（3.8±1.3）cm，which was significantly lower than that of the control group[（8.2±2.4）cm]（P<0.05）.The stone location time of the observation group was（5.2±2.4）min，which was significantly shorter than the control group[（12.1±3.2）min]（P<0.05）.The primary clearance rate of the observation group was 90.0%，which was significantly higher than that of the control group（80.0%，P<0.05）.The secondary treatment rate of the observation group was 10% and the three treatment rates were 0，which were significantly lower than the control group（20.0% and 7.7%，respectively），all P<0.05.There was no significant difference in the number of hematuria，renal hematoma and urinary infection between the two groups（P>0.05）.Conclusion：Transthoracic ultrasonography is more accurate than traditional dorsal localization，which is beneficial to further improve the ESWL efficacy of upper ureteral stones，and has high safety.It is worthy of clinical application.

Key words: ultrasonography, extracorporeal shock wave lithotripsy, upper ureteral stones, efficacy

彭华荣, 孙魁, 冯子驹. 经腹侧与经背侧超声定位在输尿管上段结石体外冲击波碎石术治疗中的效果比较[J]. 临床外科杂志, 2019, 27(2): 126-128.

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