输尿管镜气压弹道碎石术治疗输尿管结石223例

Treatment of 223 cases of ureteral stones with ureteroscopic pneumatic ballistic lithotripsy

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。方法将223例249侧输尿管结石患者分为3组,并对151侧下段输尿管结石,56侧中段结石,42侧上段结石临床治疗效果进行回顾总结。结果输尿管气压弹道碎石术治疗输尿管各段结石均可取得很好的治疗效果。下段结石清除率98.0%(148/151),中段结石清除率达94.6%(53/56),上段结石清除率达88.1%(37/42)。其中并发症的发生率为8.5%(19/223),包括结石移位、输尿管穿孔、改开放手术、发热等。结论输尿管镜气压弹道碎石术是一种安全有效的治疗输尿管结石的方式,尤其对中下段结石、体外冲击波碎石术处理失败的结石及伴肾绞痛者是一种很好的方法。

[Objective] To evaluate the clinical effectiveness of ureteroscopic pneumatic ballistic lithotripsy for the treatment of ureteral stones. [Methods] We retrospectively reviewed our experience with ureterescopic pneumatic lithotripter in 247 sides of 223 patients with ureteral calculi. These patients were divided into three groups, of which group 1 consisted of 151 cases with stones located lower urinary tract and group 2 of 56 cases with stones located middle urinary tract and group 3 of 32 cases with stones upper urinary tract. [Results] The single-session success was 96%（238/247）, 98%（148/151） in the lower segment, 94.8% in the middle segment, and 88.1%（37/42） in the upper segment. The postoperative complication rates were 8,5%（19/223）. There consisted stone migration, perforationsof urele requiring open surgery, and fever（above 37o）, et al. [Conclusions] Ureterescopic pneumatic ballistic lithotripsy is safe and effective, especially for patients with midlle or lower ureteral stones and aborted ureteral calculi with ESWL.