输尿管镜气压弹道碎石治疗输尿管结石136例分析

Treatment of Ureteral Calculi with Ureteroscope and Pneumatic Lithotripsy:A Report of 136 Cases

目的总结输尿管镜气压弹道碎石治疗输尿管结石的临床效果。方法采用F8～9.5WOLF硬性输尿管镜、EMS气压弹道碎石机治疗136例输尿管结石。结果输尿管镜直视下一次碎石成功132例,成功率97.6%(132/136),上段、中下段输尿管结石治疗成功率分别为86.7%和98.4%。1～6周内结石全部排净。1例因置镜失败改开放手术,1例因输尿管穿孔改开放手术,2例因输尿管上段结石上移至肾脏行ESWL。结论输尿管镜气压弹道碎石是治疗输尿管中、下段结石的有效方法之一,具有碎石率高、安全、并发症少、操作简单的优点。

Objective To evaluate the clinical efficacy of pneumatic lithotripsy under ureteroseope in the treatment of ureteral calculi. Methods A total of 136 cases of ureteral calculi were treated by using F 8 - 9.5 wolf rigid ureteroscope and EMS pneumatic lithotripter. Results Successful lithotripsy under ureteroscope was achieved on one session in 132 cases, with a success rate of 97.6% （ 132/136）. While the rate of upper segment and middle and distal was 86.7% and 98.4% respectively. Calculi were entirely extracted within 1 to 6 weeks. The open surgery were required in 2 cases, one case because of failed ureteroscope insertion, another case because of Ureteral perforation. Upper ureteral stones moved into the kidney in 2 cases, both of them under- went the extracorporeal shock wave lithotripsy （ESWL）. Conclusion Pneumatic lithotripsy under ureteroscope is an effective method for treating mid lower ureteral calculi,with advantages of high efficiency, safety, minimal invasion, less complications and simplicity of performance.