腔内弹道碎石加ESWL联合治疗复杂上尿路结石的临床观察

The combination of endourological techniques and extracorporeal shork wave lithotripsy in the treatment of complex upper urinary tract calculi

目的 :探讨输尿管镜下气压弹道碎石、体外冲击波碎石 ( ESWL )及经皮肾穿刺取石联合治疗复杂性上尿路结石的疗效。方法 :自 1998年 8月～ 2 0 0 0年 12月分别采用输尿管镜下气压弹道碎石、ESWL及经皮肾穿刺取石联合治疗复杂性上尿路结石 13 3例。结果 :结石总排净率为 90 .2 % ( 12 0 / 13 3 ) ,其中肾铸形结石排净率为87.9% ( 2 9/ 3 3 ) ,输尿管结石排净率为 91.0 % ( 91/ 10 0 )。并发症主要为输尿管穿孔及顽固血尿 ,占 3 .7%。结论 :采用此联合方法治疗复杂性上尿路结石的排净率高 ,损伤小 ,可有效地避免开放手术之痛苦。

Purpose:To discuss the combination of ureteroscopy, pneumatic lithotripsy, extracorporeal shork wave lithotripsy and percutaneous nephrolithotomy in the treatment of complicated upper urinary calculi (kidney staghorn stone, large ureteral calculi, ureter stone street, etc).Methods:Between August 1998 to December 2000, 133 patients with complicated upper urinary tract calculi were treated with above mentioned treatment.Results:Total stone free rate 90.2 % (122/133), kidney staghorn stone group 87.9 % (29/33), ureteral stone group 91% (91/100). Complications were observed in 3.7 %, cases, mainly perforation of ureter and persistent hematuria.Conclusions:Treatment of complicated upper urinary calculi with this combined method has been safe, effective, less invasive and can avoid open surgery.