上尿路结石1349例治疗分析

Analysis of treatment of 1 349 cases of upper urinary tract stone

目的:探讨上尿路结石的治疗方法。方法:对1349例上尿路结石患者的临床分类及治疗方法进行回顾性分析。其中单纯性肾结石543例,多发及复杂性肾结石229例,输尿管结石577例。结果:本组ESWL治疗814例,占60.3%;手术取石143例,占10.6%;腔内碎石392例,占29.1%;肾切除22例,占1.6%。ESWL组3个月内结石排净597例,占73.3%;转手术或腔内碎石187例,占26.7%;392例腔内碎石效果不佳改手术取石17例,占4.3%。结论:单纯性肾结石和输尿管结石首选ESWL治疗,手术取石时应注意并发症的发生,肾切除应严格掌握适应证,输尿管镜及肾镜下的气压弹道碎石术治疗上尿路结石是其发展方向。

Objective：The goal of this paper to analyze and discuss the treatment methods of upper urinary tract stone. Methods：Clinical classification, review and analysis of treatment methods to 1 349 patients with upper urinary tract stone were conducted. In this control group, 543 cases with simple kidney stone, 229 cases with crinosity complex kidney stone and 577 cases with urteral stone were identified. Results： ESWL therapy was used to treat 814 eases （60. 3%）. In removing stone through surgery, there were 143 cases （10.6%）. With intracavity gravel, there were 392 cases （29. 1%）. With Nephrectomy, there were 22 cases （1.6%）. In this ESWL group, 597 cases were cured. Removal stone rate with 73.3% was achieved within 3 months. 187 cases changed to surgery and intracavity gravel （26. 7%）. Among 392 cases failed intracavity gravel, 17 cases changed to surgery （4. 3%）. Conclusion： Patients with simple kidney stone and urteral stone should first treat with ESWL therapy. If surgery is needed, be caution of complications. Nephrectomy should strictly control adaptation disease. Atmospheric pressure ballistic trajectory gravel treatment to upper urinary tract stone under ureteroseopy and kidney scope is the development direction.