【摘要】 目的探讨输尿管镜气压弹道碎石术的疗效、预防及并发症。方法回顾性分析经输尿管镜气压弹道碎石术治疗的227例输尿管结石患者的临床资料,统计碎石成功率及分析12例并发症原因。结果一次性碎石成功率94.7%(215/227)。其中输尿管上段结石成功率为82.2%(37/45),中段结石为96.6%(57/59)、下段结石为98.4%(12l/123),术后1～3个月结石排净率为100%。随访时间为2～15个月,复查B超显示肾积水减轻或消失,部分病人复查KUB十IVU未发现输尿管狭窄。并发症发生率为6.2%,主要发生在技术开展的初期。结论该技术成功的关键在于好的输尿管置镜技巧、保持术野清楚、结石适当固定、冲水压力的控制以及碎石操作的技巧。该技术是目前治疗输尿管结石的一种安全、有效、微创的方法,尤其适用于输尿管中下段结石。更多还原

【Abstract】 [Objective] A discussion of how to improve the procedure of Transureteroscopic Pneumatic Lithotripsy;the prevention of,and reduction of recurrence.[Methods] A re-evaluation and analysis of 227 case materials of patients who had been treated by Transureteroscopic Pneumatic Lithotripsy(TPL)for Ureteral Calculi.(UC);a statistical analysis of successful treatment of calculi and an analysis of 12 cases of recurrence.[Results] First-time success rate achieved 97%(215/227).Among these success,82.2% are of upper segmental UC(37/45);a middle segmental UC success rate of 96.6%(57/59);and a lower segmental UC success rate of 98.4%(121/123),post-operative follow up during the period of 1～3 months showed a 100% success rate of complete removal.In subsequent follow-ups over a period of 2-15 months using B ultrasound examination showed fluid buildup on the kidney either reduced or eliminated.A few patients were re-examined using KUB+IVU and there was no incidence of urethral narrowing.Reoccurrence was limited to 6.2% of cases,which were mostly due to events in the first stages of the procedure.[Conclusion] The overall success rate using this procedure was due to proper alignment of the transureteroscope,maintenance of a clear view of the insertion,the stability of the calculi,maintenance of proper pneumatic pressure and calculi manipulation and complete removal.This procedure is a method for the safe,effective and reduction of patient injury in removing calculi,especially for middle and lower segmental procedures.更多还原