ESWL治疗输尿管结石83例失败原因

Causes of failure of ESWL for ureteral calculi

目的探讨输尿管结石采用体外冲击波(ESWL)治疗失败的原因。方法28例输尿管结石患者采用ESWL治疗对其中碎石失败者改行输尿管切开取石术及输尿管镜取石术。结果在3631例患者中83例碎石失败,其中81例改行输尿管切开取石术及输尿管镜取石术。术中发现完整结石64例,17例结石粉碎或部分粉碎,但未能全部排出。输尿管明显病变72例,其中狭窄21例,管壁增厚16例,息肉15例,肉芽组织包裹结石12例,结石嵌顿6例,输尿管扭转畸形2例。结论对失败的原因归结为:(1)结石过大(2)结石在输尿管停留时间过长;(3)输尿管病理改变明显;(4)

Objective To assess the causes of failure of ESWL for ureteral calculi. Methods Cases who failure of ESWL for ureteral calculi were observed on ureterolithotomy or ureteroscopic treatment. Results 3631 cases of ureteral calculi were treated by ESWL,the procedure failed in 83 cases. Of these,81 cases were treated by ureteral lithotomy and ureteroscopy calculi not fragmented in 64 cases and fragmented or partly fragmented in 17 cases. Ureteropathy were observe in 72 cases, adhesive ureterostenosis in 21 ,mutual thickening and sclerosis of ureteral wall in 16, inflammatory ureteral polypin 15,encapsulation of calculi by grenulation tissue in 12, incarcerated calculi in 6 and twisting deformity of the ureter in 2 conclusion. Causes of treated failure were (1)the stone being too big (2)calculus being incarcerated at the same spot for a long period (3)ureteropathy (4)poor kidney function on the effected side.