输尿管镜下气压弹道碎石治疗输尿管结石的临床研究

Clinical Analysis of the efficacy of Pneumatic Ureteroscopic Lithotripsy for the Treatment of Ureteral Calculi

目的探讨输尿管镜下气压弹道碎石术(URL)治疗输尿管中、下段结石的有效性和安全性。方法采用输尿管镜下气压弹道碎石术治疗输尿管中下段结石200例(225侧),其中输尿管中段结石70侧,下段结石155侧。并总结其临床疗效和并发症发生情况。结果输尿管中、下段结石的排净率分别为94%和99%,并发症为7%(进镜失败改为输尿管内置双J管5例,输尿管穿孔5侧,严重血尿2例,术后发热3例)。漏诊输尿管结石合并输尿管癌1例。结论输尿管中、下段结石应首选输尿管镜下气压弹道碎石术,它是一种安全、有效的方法。

Objective To investigate the efficacy of pneumatic ureteroscopic lithotripsy for calculi. Methods Two hundreds of patients with ureteral calculi （70 cases of middle uretheral the treatment of ureteral stones and 155 cases of lower ureteral stones） underwent pneumatic ureteroscopic lithotripsy and its clinical efficacy, complications were evaluated. Results The stone-free rates in patients with middle and lower ureteral calculi were 94;, 99; respectively. The complication rate was about 7; （Insertion of double J stent in 5 cases because of ureteroscope failing to enter the ureter, severe hematuria in 2 cases, postoperative fever in 3 cases, and missed diagnosis in 1 case with ureteral carcinoma）. Conclusion Pneumatic ureteroscopic lithotripsy is minimally invasive sugery of choice for lower utreteral calculi because of its safety and efficacy.