输尿管镜气压弹道碎石术治疗输尿管结石

Pneumatic lithotripsy through ureteroscope for treating ureteral calculi

目的：总结分析经尿道输尿管镜气压弹道碎石术治疗输尿管结石的疗效及其安全性。方法应用输尿管镜气压弹道碎石术治疗920例输尿管结石，其中输尿管上段结石259例，输尿管中段结石375例，输尿管下段结石286例。结果920例输尿管结石单次成功率94％（864／920），失败率6％（56／920）。失败原因：28例因输尿管口畸形狭窄而上镜失败，24例碎石过程中部分结石进入肾内，52例失败病例在留置双 J管条件下术后辅助冲击波体外碎石治疗。4例因既往有输尿管手术史或多次 ESWL 史，结石远端输尿管明显扭曲或狭窄，术中输尿管镜试图扩张通过而发生穿孔。结论输尿管镜气压弹道碎石术治疗输尿管结石有效，微创、安全、经济，是治疗输尿管结石特别是输尿管中、下段结石的首选治疗方法，特别适合在基层医院开展。

Objective To evaluate the efficacy and safety of the pneumatic lithotripsy through ureteroscope for the treatment of ureteral calculi.Methods A total of 920 patients underwent ureteroscopic lithotripsy using pneu-matic lithotripsy 259 upper,375 middle,and 286 lower ureteral stone were treated.Results The overall successful fragmentation rate for all levels of ureteral stones in a single session achieved 94.0% （864 /920）,failure rate 6.0%（56 /920）.28 cases failed because of ureteral stricture.24 cases of stone moved up into the kidney.All worst -cases were in dewelled shock wave lithotripsy ESWL.Conclusion Ureteroscopic lithotripsy using pneumatic lithotripsy is a highly effective,minimally invasive and safe therapy for ureteral calculi.It is indicated as a first choice for treatment patients with ureteral stones,especially for the ones with the middle and lower uneteral stones.Develop particularly suitable for basic hospital.