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目的:探讨输尿管上段结石的最佳治疗方法。方法:回顾性分析、比较体外冲击波碎石(ESWL)、逆行输尿管镜碎石术(URL)、后腹腔镜输尿管切开取石术(RLU)3种方法治疗的286例输尿管上段结石患者的临床资料。结果:行ESWL治疗163例,结石横径0.7～1.5cm,平均1.21cm,1个月碎石清除率88.6%;行URL术65例,结石横径0.8～1.8cm,平均1.40cm,1个月碎石清除率92.3%;行RLU术58例,结石横径1.8～2.5cm,平均1.96cm,取石成功率100%。结论:输尿管上段结石横径≤1.0cm的首选ESWL治疗,横径>1.0cm的应选择URL或RLU治疗。
Objective: To investigate the best treatment of upper ureteral calculi. Methods: The clinical data of 286 patients with upper ureteral calculi treated with ESWL, retrograde ureteroscopic lithotripsy (URL) and retroperitoneal ureterolithotomy (RLU) were retrospectively analyzed. . Results: 163 cases were treated with ESWL, the average diameter of stones was 0.7 ~ 1.5cm, the average diameter was 1.21cm, and the rate of gravel clearance at 1 month was 88.6%. There were 65 cases underwent URL technique and the diameter of stones was 0.8 ~ 1.8cm with an average of 1.40cm Month clearance rate of 92.3%; line RLU surgery in 58 cases, the diameter of stones 1.8 ~ 2.5cm, an average of 1.96cm, stone success rate of 100%. CONCLUSIONS: Preferred ESWL for transversal ureteral calculi with a diameter of ≤1.0cm and URL or RLU for transversal diameter> 1.0cm should be selected.