ES WL后输尿管切开取石原因分析(附32例报告)

The cause analysis of ureterolithotomy after the treatment of ESWL for ureteral calculi

目的 :分析 32例输尿管结石患者在ESWL后结石未能有效排出 ,改行外科干预的原因。方法 :随访分析 32例患者ESWL治疗 5 2次 ,平均为 1.6次的临床资料。结果 :32例输尿管结石患者均再行输尿管切开取石术或输尿管镜取石术 ,术中发现多数结石不同程度粉碎 ,部分结石嵌顿或粘附在输尿管粘膜表面。结论 :输尿管结石在行ESWL之前应慎重评估。下段输尿管结石首选ESWL。中上段输尿管结石 ,尤其并发肾积水、结石停留时间过长、结石较大、或已证明输尿管下段有病变者不宜采用ESWL治疗。输尿管结石经ESWL治疗 1～ 2次 ,若结石不能有效排出 ,应尽早外科干预。

Purpose: To analyse the cause 32 cases of ureteral for ureteral calculi after failure to ESWL. Methods:32 cases were treated by ESWL for 52 times, the average time is 1.6 times.Results:The following were observed on ureterolithotomy: Most of the stones were fragmented partly, some of the stones were impacted or stuck to the surface of ureteral mucosa and could not be drained.Conclusions:It was suggested that ESWL should be used carefully in the treatment of ureteral stones.ESWL was more suitable for the lower ureteral stones.The patient who had the following conditions should be considered for surgery.The first,the stone lies on middle upper ureteral stones,especially with hydronephrosis.The second,the stone has been locked for a long time.The third,the calculus is too big or the lower ureteropathy.