输尿管镜下气压弹道碎石术治疗ESWL术后未排净的输尿管结石

Ureteroscopic pneumatic lithotripsy for aborted ureteral calculi of ESWL(Report of 71 cases)

目的:探讨ESWL术后未排净输尿管结石的治疗方法。方法:对71例ESWL术后未排净的输尿管结石患者,应用输尿管镜下气压弹道碎石术治疗。结果:69例中63例原位一次碎石成功,6例有较大结石返回肾脏,加行1次ESWL,术后3个月复查结石均排净。仅1例结石下方输尿管明显狭窄进镜困难、另1例结石下方有较大息肉进镜时出现输尿管穿孔而改行开放手术取石。结论:输尿管镜下气压弹道碎石术治疗ESWL术后未排净的输尿管结石安全、有效,可作为本病的首选治疗。

Objective：To evaluate clinical efficacy of ureteroscopic pneumatic lithotripsy for aborted ureteral calculi with ESWL. Methods：Clinical data of 71 cases of ureteral calculi patients treated with ureteroscopic pneumatic lithotripsy after unsuccessful ESWL were analyzed. Results： Ureteroscopic lithotripsy was succed at one time in 63 patients. 6 patients had big fragment returned kidney. Combining with one time of ESWL, all patients discharged thoroughly after three month. In one case ureteroscope could not pass through the narrow ureter to reach the stone,and in another case the perforation was found in the ureter. The two patients were treated with open sur gery. Conclusions：Ureteroscopic pneumatic lithotripsy is a safe and effective treatment modality for aborted ureteral calculi with ESWL. It should be considered as the first choice of treatment.