输尿管镜下气压弹道碎石术治疗输尿管结石136例

输尿管镜气压弹道碎石术治疗输尿管结石(附112例报告)

目的探讨输尿管镜气压弹道碎石术治疗输尿管结石的疗效。方法采用输尿管镜下气压弹道碎石术治疗输尿管结石136例,其中输尿管上段结石12例,中段结石50例,下段结石74例。结果一次性碎石成功124例,占91.1%,碎石失败12例,占8.9%,其中4例输尿管上段结石冲回肾脏,留置双J管后行ESWL治愈,另外3例输尿管穿孔和5例进镜失败患者均立即开放手术治愈。结论输尿管镜气压弹道碎石术治疗输尿管结石具有微创、安全、有效等优点,可作为输尿管中、下段结石的首选治疗方法。

Objective To present the results achieved in the treatment of ureteral calculi by rigid ureteroscopy with a pneumatic lithotripter.Methods 112 patients with ureteral calculi underwent pneumatic lithotripsy by rigid ureteroscopy in our hospital.The calculi were in the proximal part(n=5),mid(n=64)and distal(n=43)of the ureter.The calculi of 60 cases were in the left,52 cases is right,bilateral two cases.Results Of the 112 cases whose stones could be accessed adequately by ureteroscopy with pneumatic lithotripsy,overall stone- free rate was 94.6 %(106 cases).In 3 cases,the stons could not be removed because them were changed to open surgery.2 cases were failed to insert the ureteroscope and changed to open surgery,one case of the distal ureteral perforation were treated by other treatment after insertion of double J catheter.60(53.6%)cases have haematuria.No ureteral mucosa denude,tear and stenosis and no infection was found.Conclusion pneumatic lithotripsy by rigid transurethral ureteroscopy is an useful,safe and efficient technique in the treatment of calculi in the mid and distal ureter.