尿道黏膜表面麻醉下输尿管镜术治疗老年人输尿管结石

Ureteroscopy in the treatment of the elderly ureter stone with urethral mucousa membrane under topical anesthesia

目的探讨尿道黏膜表面麻醉下输尿管镜术治疗老年人输尿管结石的方法及临床效果。方法 2%利多卡因作尿道黏膜表面麻醉后,对老年人输尿管结石68例(72侧)施行输尿管镜术治疗。结果上段结石3侧,2侧成功治愈,1侧移位肾盂,留置双J管后行体外冲击波(ESWL)治疗成功。中段结石12侧,9侧成功治愈,3侧失败(1侧并发输尿管穿孔)转开放手术。下段输尿管结石57侧全部治愈。术中16侧出现患侧腰部胀痛给予肌注盐酸哌替啶。气压弹道碎石62侧。直接用输尿管钳钳夹取石7侧。手术时间5～120min,平均45min。结论尿道黏膜表面麻醉下输尿管镜术治疗老年人输尿管结石,既简便又安全可靠,值得应用。

【Objective】To discuss the treatment and clinical effect of the ureteroscopy in the treatment of the elderly ureter stone with urethral mucousa membrane under topical anesthesia.【Methods】After 2% lidocaine topical anesthesia for urethral mucosa,68 cases on the elderly of these conditions were treated with ureteroscopy treatment.【Results】Of the 3 proximal ureteral calculi,2 are successfully treated,one shifts to renal pelvis,double-J later extra-corporeal shock wave（ESWL） treatment succeeds.In the middle 12,9 successfully treated,3 failed（1 of the ureter complicated by perforation） to open surgery.57 of the distal ureteral calculi cure.16 in the affected side of the back pain appears to give piperazine hydrochloride injection for the set.This group of pneumatic lithotripsy has 62 sides.7 pull the stone directly with pliers.Operation time from 5 to 120 min,45 min on average.【Conclusions】Ureteroscopy in the treatment of the elderly ureter stone with urethral mucous membrane under topical anesthesia is easy secure and highly effective.