输尿管肾镜气压弹道碎石术治疗输尿管膀胱尿道结石(附152例报告)

Treatment of ureter, bladder, and urethra stones with ureteroscope pneumatic lithotripsy (Report of 152 cases)

目的 :探讨输尿管肾镜气压弹道碎石术治疗输尿管、膀胱、尿道结石的疗效与安全性。方法 :回顾性分析经尿道输尿管肾镜气压弹道碎石术治疗的 15 2例尿道、膀胱、输尿管结石患者的临床资料。结果 :4例男性尿道结石和 2 0例膀胱结石均碎石成功 ,输尿管中下段结石 10 9例 ,10 7例成功 ,2例输尿管口狭窄改用ESWL碎石成功 ;输尿管上段结石 19例 ,12例原位碎石成功 ,2例输尿管镜插至输尿管中段上行受阻插管改ESWL碎石成功 ,5例部分碎石冲入或推入肾内置引流管后行ESWL碎石成功。结论 :输尿管肾镜气压弹道碎石术治疗输尿管及其以下尿路结石 ,具有安全可靠、损伤小、术后恢复快等优点 ,是微创治疗的有效方法之一。对于输尿管上段结石 ,将该手术配合ESWL也能取得满意疗效。

Objective:To evaluate the clinical use of ureteroscope pneumatic lithotripsy on the treatment of ureter, bladder and urethra stones.Methods:152 cases of these conditions were treated with ureteroscope pneumatic lithotriptor.Results:4 male cases of urethra stones and 20 cases of bladder stones were successfully cured by this method; 107 of total 109 middle and lower section of ureter stones were cured, and failed in 2 cases due to stenosis of ureter and ESWL were performed; 12 of 19 cases of upper section of ureter stones were fragmented at the original sites, 2 cases were changed to ESWL because of middle part obstruction of ureter, 5 cases of upper section stones of ureter were pushed into kidneys, drainage canal were settled and ESWL were performed.Conclusions:Treatment of lower ureteral stones with ureteroscope pneumatic lithotriptor was a safe, effective, rapid recovery and less invasive method; Treatment of upper ureteral stones with ureteroscope pneumatic lithotriptor combined with ESWL couldalso achieve satisfoctory results.