【作者】 石家齐； 贾本忠； 谷江； 顾昌世； 汪柏林； 陈方敏； 吴志平； 宋昭祥； 唐平； 由慧娟； 谢敏；

【Author】 Shi jia qi, Jia Benzhong, Gu Jiang, et al. Department of Urology, the Affiliated Hospital of Guiyang Medical college, Guiyang 550004.

【机构】 贵阳医学院附属医院泌尿外科；

【摘要】 目的总结和探讨输尿管镜下气压弹道碎石术治疗上尿路结石的临床经验和对策。方法回顾性分析输尿管镜配合气压弹道碎石机对3000例上尿路结石进行腔内碎石处理的临床资料。其中输尿管结石2956例,其中左侧1530例,右侧1156例,双侧270例;上段974例,中下段1982例。肾盂结石 44例。单侧单发结石2560例,单侧多发结石440例,44例肾盂结石中同时并发输尿管结石36例。输尿管结石横径2一13 mm,长径5～22 mm,肾盂结石横径12。18 mm,长径10～20 mm。其中620例曾经行 ESWL治疗。结果输尿管人镜成功率99．1％(2974／3000)。输尿管上段腔内气压弹道碎石成功率83．2％ (810／974),失败的164例中,92例结石术中被冲至肾盂,60例因结石以下段输尿管过度狭窄、扭曲或息肉,使碎石未能成功;输尿管口未能人镜9例,2例发生输尿管穿孔,1例输尿管撕裂。1982例输尿管中下段结石,成功率97．0％(1922／1982),失败的60例中,管口未能入镜17例,15例结石被冲至输尿管上段或肾盂,结石以下段输尿管狭窄、息肉致不能上镜接触结石28例。结论使用输尿管镜局部麻醉下气压弹道碎石治疗上尿路结石安全有效,创伤小,费用低廉,对中下段输尿管结石处理最为适宜。更多还原

【Abstract】 Objective To summary the clinical experience about treatment of upper urinary calculi with ureteroscopy and pneumatic lithotriptor. Methods Retrospective analysis of clinical data of 3000 cases upper urinary calculi with ureteroscopy and pneumatic lithotriptor. Results The successful rates respectively were achieved to 83.2% (810/944) in treatment of the superior segment urinary calculus and 97.0% (1922/1982) in midst and lower segment urinary with above method. There is a major complication of urinary infection in the course of treatment of upper urinary calculus. Conclusions It is an effective, safe and mini-invasive method and was the most suitable method for midst and lower segment urinary calculus.更多还原