【摘要】 目的探讨输尿管镜下电子动能弹道碎石治疗输尿管结石的疗效。方法2002年9月~2008年7月对381例输尿管结石采用日本Olympus F8.4/9.8输尿管硬镜结合德国WALZ.KA.1000型电子动能碎石机进行碎石。根据结石的大小及硬度,采用A~C档,将结石击碎至直径3 mm以下(碎石杆作参照),较大的石碎用取石钳取出,输尿管镜通过结石嵌顿部位后继续上行至肾盂,退镜后顺导丝放置F5双J管3~4周,术后留置尿管2~3 d。结果碎石成功率95.5%(364/381),其中上段结石碎石成功率89.7%(52/58),中段为94.2%(129/137),下段为98.4%(183/186),17例结石冲回肾盂,结合体外冲击波治疗。365例随访3~12个月,平均5个月,1个月内结石排净为100%,未出现输尿管狭窄、尿路感染等并发症。结论输尿管镜下电子动能弹道碎石术治疗输尿管结石方法安全,疗效可靠。更多还原

【Abstract】 Objective To investigate the therapeutic effect of transurethral ureteroscopic electrokineitic lithotripsy for ureteral calculi. Methods A retrospective analysis was made on 381 cases of ureteral calculus treated with transurethral ureteroscopic electrokineitic lithotripsy from September 2002 to July 2008.An Olympus F8.4/9.8 rigid ureteroscope and WALZ.KA.1000 electrokinetic lithotripter were used.According to the size and solidity of the stone,grades A-C were employed to break the stone into particles less than 3 mm in diameter.Afterwards,the visible stones were removed by stone-taking pliers.For the calculi incarcerated in the ureter,a ureteroscope was inserted upwards into the renal pelvis,and then a F5 double-J tube was placed for 3 to 4 weeks.After the operation,a Foley catheter was indwelled for 2 to 3 days. Results In this series,the success rate of lithotripsy was 95.5%(364/381) [89.7%(52/58) for proximal ureteral calculi,94.2%(129/137) for middle ureteral calculi and 98.4%(183/186) for lower ones].In 17 cases,stone was pushed back into the renal pelvis and the patients were thus converted to extracorporeal shock wave lithotripsy(ESWL).A mean of 5-month follow-up(3-12 months) was achieved in 365 cases,the clearance rate of the stones was 100% in one month.No stenosis or infection of the urinary system occurred. Conclusion Transurethral ureteroscopic electrokineitic lithotripsy is safe and effective for the treatment of ureteral calculus.更多还原