ESWL治疗输尿管石街的研究

The experience of ESWL treatment on ureteral stone street

目的:总结分析输尿管石街ESWL的技巧与方法,旨在提高其单纯ESWL的成功率。方法:将117例输尿管石街分为粉末型(26例),蛇头型(72例),石块型(19例)。不同类型的石街按不同治疗方法处理。结果:①粉末型石街长度≤5cm21例,仅药物对症排石治疗2周排净13例,4周排净8例;长度>5cm5例,ES-WL一次2周排净3例,4周排净2例。②蛇头型石街72例,其中ESWL一次2周排净38例,4周排净22例,3个月排净5例,有7例2周复查时行第二次ESWL,2～4周复查均排净。③石块型石街19例,ESWL一次2周排净3例,4周排净4例,3个月排净5例;其中有7例2周复查时行第二次ESWL,4周复查排净3例,4例行第三次ESWL,2例2个月排净,1例3个月复查排净,1例历时半年排净。上述117病例中有9例出现患侧肾绞痛或(和)发热、明显肉眼血尿,予抗炎解痉等对症治疗或感染控制后即予ESWL,症状均缓解或消失,余病例均无严重并发症。结论:ESWL治疗输尿管石街具有清除率高、损伤少、安全性高、并发症少、可重复治疗等优点,对于碎石机性能较好、ESWL技术成熟的医疗单位,尤其对于无腔内微创治疗条件的医院,目前仍可作为首选的治疗方法。

Objective：To summarize and analyze the skills and methods of ESWL treatment on ureteral stone street was to improve their success rate of only ESWL. Methods： 112 cases of ureteral stone street were divided into three types：（1）Powder-Street （26 cases）; （2）Snakehead-Street （72 cases）, （3）Block-Stone Street （19 cases）. Different types of Stone Street were treated according to different methods by ESWL or only by drug therapy. Results.（1）Powder-Street had 26 cases, which the length was ≤ 5 cm had 21 cases, 13 cases lithecboled cleanly only by drug therapy in two weeks, 8 cases lithecboled cleanly in four weeks; which the length was 〉 5 cm had 5 cases, 3 cases lithecboled cleanly by ESWL once in two weeks, 2 cases in four weeks. （2）Snakeheads-Street had 72 cases, 38 cases lithecboled cleanly by ESWL once in two weeks , 22 cases in four weeks, 5 cases lithecboled cleanly by ESWL once in three months ,7 cases were taken the second ESWL in times of two weeks when returnvisited, all of 7 cases lithecboled cleanly in two weeks to four weeks. （3）Block-Stone Street had 19 cases , 3 cases lithecholed cleanly in two weeks by ESWL once , 4 cases in four weeks, 5 cases lithecboled cleanly in three months, 7 cases of which were taken the second ESWL in times of two weeks when returnvisited, another 4 cases were taken the third ESWL in times of four weeks, 2 cases litheeboled cleanly in two months , one case lithecboled cleanly in three months, and another one case until six months. 9 cases of all of the 117 cases had effected renal colic or （and） fever, obviously nakea hematuria, to be taken the symptomatic treatment such as anti-inflammatory spasm or to be taken the ESWL while the infection had been controled, symptoms were eased or disappeared, no serious cases complications. Conclusions： ESWL treated ureteral stone street with a high clearance rate, less injuries,high safety, less complications, and repetitiveness. If the medical units have a better lithotripster and technology, especially to the hospital has not minimally invasive treatment,still regards it as the preferred treatment.