摘要
目的探讨输尿管镜下气压弹道碎石术治疗输尿管结石的效果。方法应用输尿管镜下气压弹道碎石术治疗输尿管结石100例。男65例，女36例，年龄18—65岁，平均40岁。输尿管上段结石10例，中段34例，下段56例。结石直径0.8～2．0cm，平均1．0cm。合并患侧肾积水94例。结果100例输尿管结石粉碎率98％（98例），1次彻底清除率91％（91例），2例结石移至肾盂者未完成手术，10例术终输尿管壁残留结石粉末，术后4wkIVU复查，残石已排空。43例（43％）术后有肉眼血尿或镜下血尿，一般1～2d内消失。100例均无穿孔、感染等并发症。结论输尿管镜直视下气压弹道碎石术治疗输尿管结石确切、安全、组织损伤小，清除彻底、并发症少，可作为输尿管中段和下段结石的首选治疗方法。
Objective To investigate the effects of pneumatic iithotripsy through rigid ureteroscope for the treatment of ureteral calculi. Methods A total of 100 patients（65 men, 35 women; age range 18 -65 years; mean age 40 years）. 10 patients had calculi in ths proximal part of the ureter; 34 in the middlepart; 56 in the distal part. and 94 cases had ipsilateral hydronephrosis. The size of the stones ranged from 0. 8 -2.0 cm in diameter. Results The overall comminution rate was 98 % （98 cases）. Of the 100 cases, 91cases（91% ） were stone free immediately after the procedure. The operation failed in 2 cases due to shift of the stone to the renal peivis. Twelve cases had residual fragments on the nyeteral wall, which were eliminated and could not be found IVU 4 weeks after operation . 43 cases （43%） had postoperative hematuria, which disappeared within 1 -2 d. None 100 cases had complications of perforation and infection. Conclusions Pneumatic lithotripsy through rigid tyansurethral ureteroscope is a safe and effective technique with less injury, less complications and complete clearanceof the calculi. Itcan be thechoice in the treatment of calculi in the middle and distal uretral.
