复式脉冲低能量体外冲击碎石术治疗上尿路结石(附717例报告)  

Treatment of renal and ureteral calculi with duplex pulse low-energy ESWL (report of 717 cases)

作　　者：张泽[1] 李逊[1] 夏明义[1] 汤凤玲[1] 龙腾[1] 陈贵珍[1] 冯桂萍[1] 欧莉莉[1] 吴开俊[1] 

机构地区：[1]广州医学院第一附属医院微创外科中心泌尿外科,510230

出　　处：《中华泌尿外科杂志》2004年第7期448-449,共2页Chinese Journal of Urology

摘　　要：目的　探讨复式脉冲HB V型低能量体外冲击碎石术 (ESWL)治疗各种上尿路结石的效果。　方法　采用复式脉冲HB ESWL VG型低能量碎石机治疗符合ESWL适应证的上尿路结石 717例 ,工作电压 3～ 9kV。其中直径≤ 2 .0cm肾结石 4 6 7例 ,平均冲击次数 2 30 0次 ;直径≤ 1.0cm输尿管结石 2 5 0例 ,平均冲击次数 2 80 0次。　结果　上中盏结石排净率 89.5 % (170 / 190 ) ,复打率 13.2 %(2 5 / 190 ) ;下盏结石排净率 81.6 % (16 9/ 2 0 7) ,复打率 17.4 % (36 / 2 0 7) ;肾盂结石排净率 92 .9% (6 5 / 70 ) ,复打率 5 .7% (4 / 70 ) ;输尿管结石总排净率 95 .2 % (2 38/ 2 5 0 ) ,总复打率 6 .4 % (16 / 2 5 0 )。碎石过程中出现轻度疼痛者 10 7例 (14 .9% ) ,治疗后出现肉眼血尿者 6 87例 (95 .8% ) ,1～ 3d后血尿消失。无肾周血肿等严重并发症。　结论　复式脉冲低能量ESWL治疗上尿路结石成功率高 ,复打率低 ,副作用少 ,无严重并发症。Objective To evaluate the efficacy, advantages and complications of duplex pulse low-energy lithotriptor for the treatment of renal and ureteral calculi. Methods A total of 717 cases of renal and ureteral calculi were treated with duplex pulse low-energy lithotriptor.The treatment voltage was 3 to 9 kV.Of the 717 cases,467 were with renal calculi of ≤2.0 cm in diameter and the average number of impulse was 2300;250 cases were with ureteral calculi of ≤1.0 cm in diameter and the average number of impulse was 2800. Results The stone-free rate after ESWL of upper-pole and mid-pole calyceal stones was 89.5% (170/190) and re-treatment rate was 13.2%(25/190);the stone-free rate of low-pole calyceal stones was 81.6% (169/207) and re-treatment rate was 17.4% (36/207);those of renal pelvic calculi were 92.9% (65/70) and 5.7% (4/70);and those of ureteral calculi were 95.2% (238/250) and 6.4% (16/250),respectively. Conclusions The treatment of renal and ureteral calculi with duplex pulse low-energy lithotripsy is highly efficacious and safe,and it has less adverse effects and no severe complication.

关 键 词：复式脉冲低能量体外冲击碎石术 上尿路结石 ESWL 心电图 

分 类 号：R699[医药卫生—泌尿科学]