输尿管镜下套石网篮配合气压弹道碎石术治疗输尿管上段结石

Treatment of upper ureteral stones with spiral stone dislodger combined with pneumatic lithotriptor under ureteroscopy

目的探讨输尿管镜下套石网篮配合气压弹道碎石术治疗输尿管上段结石的临床疗效。方法采用输尿管镜下套石网篮配合气压弹道碎石术治疗输尿管上段结石106例。结石横径4～12 mm,纵径6～15 mm。结果一次性碎石成功率87．7％(93／106),8例术后结合体外震波碎石治愈,术中5例改开放手术,1例输尿管穿孔。结论输尿管镜入镜成功是碎石的前提,结石适当固定是碎石成功的关键,套石网篮是固定结石的有效方法之一。

Objective To evaluate the effectiveness of spiral stone dislodger combined with pneumatic lithotriptor under urctcroscopy for managing upper uretcral stones. Methods 106 patients with upper ureteral stones with spiral stone dislodger combined with pneumatic lithotriptor under ureteroscopy were treated. The transverse diameter of the stones was 4-12mm and the vertical length 6- 15mm. Results 87.7 % （93/106） stones were fragmented for one session of treatment. 8 cases were pushed upward then undergoing extracorporeal shock wave lithotripsy（ESWL） after surgical operations. Operations in 5 cases had to be changed to open surgery,and ureteral perforations happened in 1 case. Conclusion Successful entrance of the uretersocop is a prerequisite for crushing the stone,appropriate fixation of the stone is the key to their crushing .spiral stone dislodger is an effective means of fixing ureteral stones.