【摘要】 目的探讨输尿管镜下气压弹道碎石术治疗输尿管结石的效果。方法应用输尿管镜下气压弹道碎石治疗输尿管结石180例。男127例,女53例,年龄14～62岁,平均38岁。输尿管上段结石18例,中段64例,下段98例。结石直径0.5～2.3cm,平均0.7cm。合并患侧肾积水89例,其中1例女性双侧输尿管下段结石并梗阻、双肾积水,肾功能不全。结果180例输尿管结石粉碎率98.3%(177例),1次彻底清除率91.7%(165例),3例结石移至肾盂者未完成手术,12例术终输尿管壁残留结石粉末,术后4周IVU复查,残石已排空。67例(37.0%)术后有肉眼或镜下血尿,多于1～2d内消失。180例均无穿孔、感染等并发症。结论输尿管镜直视下气压弹道碎石术治疗输尿管结石确切、安全、组织损伤小,清除彻底、并发症少,可作为输尿管中段和下段结石的首选治疗方法。更多还原

【Abstract】 Objective To investigate the effects of pneumatic lithotripsy through rigid ureteroscope for the treatment of ureteral calculi. Methods A total of 180 patients (127 men,53 women;age range, 14- 62 years;mean age,38 years) with ureteral calculi underwent pneumatic lithotripsy through rigid ureteroscope in our hospital.Of them,18 patients had calculi in the proximal part of the ureter;64,in the middle part;98,in the distal part.One female had distal ureteral calculi,obstruction and hydronephrosis bilaterally with renal dysfunction; and 89 cases had ipsilateral hydronephrosis.The size of the stones ranged from 0.5 cm to 2.3 cm in diameter. Results The overall comminution rate was 98.3% (177 cases).Of the 180 cases,165 (91.7%) were stone free immediately after the procedure. The operation failed in 3 cases due to shift of the stone to the renal pelvis. Twelve cases had residual fragments on the ureteral wall,which were eliminated and could not be found on IUV 4 weeks after operation.Sixty-seven cases (37.2%) had postoperative hematuria, which disappeared within 1-2 d.None of 180 cases had complications of perforation and infection. Conclusions Pneumatic lithotripsy through rigid transurethral ureteroscope is a safe and effective technique with less injury,less complications and complete clearance of the calculi.It can be the first choice in the treatment of calculi in the middle and distal ureter.更多还原