مقارنة نتائج تفتيت حصيات الثلث السفلي للحالب بواسطة الأمواج الصادمة من خارج الجسم (ESWL) وتفتيتها بالليزر عبر المنظار الحالبي
Abstract
الهدف الأساسي من الدراسة هو اختيار الأفضل والمثلى في تفتيت حصيات أسفل الحالب، ومقارنتها مع الدراسات العالمية. شملت الدراسة 280 مريض لديهم حصيات أسفل الحالب راجعوا مشفى تشرين الجامعي ومشفى الأسد الجامعي بين عامي 2016-2017، حيث خضع 64 مريض للتفتيت بالليزر عبر المنظار الحالبي، وخضع 216 مريض للتفتيت بالأمواج الصادمة من خارج الجسم(ESWL)،تراوحت أعمار المرضى بين 19-72سنة وكان العمر الوسطي تقريباً 37 سنة، كانت نسبة نجاح تفتيت الحصيات في أسفل الحالب باستخدام المنظار الحالبي والليزر 97%( 100% في الحصيات < 1 سم، 95% في الحصيات>1سم)،أما تفتيت الحصيات بالأمواج الصادمة من خارج الجسم (ESWL) فكانت بحدود 72%(84% في الحصيات < 1سم، 36% في الحصيات >1سم).
إنَّ تفتيت الحصيات أسفل الحالب من خلال المنظار الحالبي بالليزر أعطت نتائج أفضل بمختلف أحجام الحصيات، أما تفتيها بالأمواج الصادمة من خارج الجسم فكنت النتائج جيدة فقط في الحصيات الأصغر من 1سم.
The main objective of the study is to select the best technique for lithotripsy of distal ureteral stones .This study included 280 patients of distal ureteral stone at Al-Assad University Hospital and Tishreen University Hospital in Latakia between 2016 and 2017. 64 patients who underwent ureteroscopic holmium laser lithotripsy and 216 patient who underwent ESWL.The ages ranged from 19-72Years, The median age was approximately 37 year.
the success rate of distal ureteral lithotripsy using uretroscope-laser was 97% (100% with stones> 1 cm, and 95% with stones< 1 cm) while it was 72% with the extracorporeal lithotripsy(84% with stones > 1 cm, and 36% with stones < 1 cm).
The best results in treating the distal uretral stones were achieved by the use of ureteroscope and laser lithotripsy, regardless of the stone size. While the extracorporeal lithotripsy the best results was only with stones< 1 cm.
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