输尿管镜下气压弹道碎石术治疗输尿管结石手术并发症及防治措施

Complications and Prevention of Pneumatic Ballistic Lithotripsy under Ureteroscope in the Treatment of Ureteral Calculus

目的:输尿管镜下气压弹道碎石术治疗输尿管结石手术并发症及防治对策研究。方法:筛选输尿管结石患者1150例,作为研究对象。所有患者行输尿管镜下气压弹道碎石术治疗输尿管结石,统计患者术后并发症的发生情况,根据患者的实际病情进行对症治疗,分析其临床治疗效果。结果:术后发生并发症患者98例,其中输尿管穿孔18例,置镜失败12例,输尿管狭窄5例,输尿管黏膜损伤14例,感染25例,肉眼血尿15例,结石残余9例,以医源性损伤、感染为主要影响因素(P<0.05)。结论:在输尿管镜下气压弹道碎石术治疗输尿管结石术中谨慎操作,减少内镜对输尿管的硬性损伤,改善患者预后情况。

Objective To discuss the complications and prevention of pneumatic ballistic lithotripsy under ureteroscope in the treatment of ureteral calculus, nethods1150 patients with ureteral calculus were selected as the study objects. All patients adopted pneumatic ballistic lithotripsy under ureteroscope for treating ureteral calculus, complication incidence of patients were recorded, and found the targeted treatment according to the actual situation and analyzed the clinical efficacy. ResultsThere were 98 patients with complications, 18 cases with perforation, 12 cases with false placing mirror, 5 cases with ureterostenosis, 14 cases with mucosal injury, 25 cases with infection, 15 cases with gross hematuria, 9 cases with resident stone, and the main influence factors were iatrogenic injury, infection （P 〈 0. 05）. CondusionThe doctors should be cautious about the operation during the pneumatic ballistic lithotripsy under ureteroscope in the treatment of ureteral calculus, reduce the hard damage of endoscope on ureter, and improve the prognosis of patients.