液电输尿管镜碎石术失败原因探讨  

Evaluation of the failure of electrohydraulic lithotrite rureterolithotripsy

作　　者：岳明[1] 刘淳[1] 刘刚[1] 刘小勇[1] 朝鲁[1] 陈锐[1] 

机构地区：[1]解放军第306医院,北京市100101

出　　处：《总装备部医学学报》2006年第4期198-199,共2页Medical Journal of General Equipment Headquarters

摘　　要：目的探讨液电输尿管镜碎石术失败的原因及其防治措施。方法选择液电经输尿管镜进行输尿管结石碎石手术失败者12例的临床资料,进行总结分析,并探讨其失败原因及防治措施。结果12例中5例由于术中结石移位致使结石进入肾盂,无法继续碎石;3例由于输尿管走行迂曲或输尿管狭窄,输尿管镜无法通过而放弃手术;1例由于结石阻塞输尿管,冲洗液引流不畅导致手术视野不清楚而停止手术;3例因为输尿管开口内陷,置镜受阻而终止手术。结论结石移位、输尿管走行迂曲或狭窄、手术视野不清及输尿管开口异常导致置镜失败,是该手术失败的主要原因。术前合理选择病例,使用适宜电极,术中适时调整冲洗液流速、压力及冲击波的参数,采取从结石边缘起碎石等措施是提高手术成功率的关键。Objective To assess the causes of the failure of electrohydraulic lithotrite ureterolithotripsy. Methods Fifty-one patients underwent retrograde ureteroscopic electrohydraulic lithotrite by ureteroscopes and the electrohydraulic lithotrite. Results Twelve patients failed to fragment the ureteral stones completely, 5 case were abandoned because of the stone migrations to the renal pelvis; 3 cases were stopped owing to the tortuosity or the narrow of the ureters; 1 case failed because operation area was not clear; 3 cases were halted due to the invagination of the opening of the ureters. Conclusions The main causes of the failure of the electrohydraulic lithotrite ureterolithotripsy are stone migrations, tortuous or narrow ureters, unclear operation area and the invagination of the opening of the ureters. Suitable cases, fitting electrode, appropriate flow rate and pressure of the fluid and shock wave parameters are important measures to elevate the success rate.

关 键 词：液电 输尿管结石 碎石术 

分 类 号：R699[医药卫生—泌尿科学]