体外震波碎石治疗输尿管结石失败原因分析

Analysis the causes of failure of ESWL to treat the Ureter stone

目的探讨输尿管结石采用原位体外冲击波碎石（ＥＳＷＬ）治疗失败的原因。方法对输尿管结石患者采用ＥＳＷＬ治疗对其中碎石失败者改用输尿管切开取石术。结果在２４２２例患者中２３例碎石失败（０．９５％），改用输尿管切开取石术治疗。结论对失败的原因归结为：①结石面积过大（横径＞１．２ｃｍ）或停留时间太长（＞３年）；②由于结石长期刺激而导致输尿管的病理改变；③结石梗阻并发严重感染导致患侧肾功能减退。④结石成份以磷酸盐居多。

Objective Reasons of failure using ESWL to treat ureteral stone were analyzed.Methods To treat ureteral stone with ESWL and the failure cases are taken out by ureterotomy.Results 2 422 cases is successful besides 23 cases and they are taken out by ureterotamy.Conclusions The main reasons of failure are:(1) stone is too large.(D>1.2 cm in diameter) or too long incarcerated in situ(>3 years) (2)stone irritation for a long period causes pathological changes(3) stone obstruction with severe infection and hydronephrosis causes dysfunction of the kidney (4) The composition of ureter stone are most of phosphate.