输尿管镜下气压弹道碎石术治疗输尿管结石(附312例报告)  

Transureteroscopic Pneumatic Lithotripsy for the Treatment of 312 Cases Ureteral Calculi

作　　者：邓健[1] 谢群[1] 曹明奎[1] 许琛[1] 胡贵祥[1] 

机构地区：[1]广东省珠海市人民医院泌尿外科,广东珠海519000

出　　处：《医学临床研究》2004年第12期1397-1399,共3页Journal of Clinical Research

摘　　要：【目的】探讨输尿管镜下气压弹道碎石术治疗输尿管结石的方法及疗效。【方法】回顾分析利用输尿管镜下气压弹道碎石术治疗输尿管结石病例 312例 ,其中输尿管上段结石 5 3例 ,中段结石 14 3例 ,下段结石 116例。输尿管上段结石利用微创经皮肾穿刺输尿管镜下气压弹道碎石术及经尿道逆行输尿管镜下气压弹道碎石术治疗 ,输尿管中下段结石均利用经尿道输尿管镜下气压弹道碎石术治疗。【结果】镜下一次碎石成功 2 71例 (86 % ) ,其中输尿管中下段结石镜下一次碎石成功 2 39例 (96 % )。术后结合体外震波碎石治疗 37例 ,术中改开放手术四例。输尿管穿孔 8例。术后随访 1～ 6个月 ,未见结石残留及输尿管狭窄。【结论】输尿管镜下气压弹道碎石术治疗输尿管结石可取得良好效果。ObjectiveTo explore the methods and therapeutic efficacy of transureteroscopic pneumatic lithotripsy(TPL) for the treatment of ureteral calculus(UC).Three hundred and twelve patients with UC treated by TPL in our hospital were analyzed retrospectively, including 53 cases of upper segmental UC, 143 cases of middle segmental UC and 116 cases of lower segmental UC. For treatment of upper segmental UC, minimally invasive percutaneous nephrolithotomy (MIPN), TPL and transurethral retrograde ureteroscopic pneumatic lithotripsy (TRUPL) were adopted ; whereas TPL was applied for treatment of middle and lower segmental UC.One-time successful ureteroscopic lithotripsy was achieved in 271 cases, accounting for 86% of 312 cases, including one-time successful ureteroscopic lithotrity in 239 cases of middle and lower segmental UC (92.3%). In addition, 37 cases undergoing extracorporeal shock wave lithotripsy (ESWL) after surgical operations, operations in 4 cases had to be changed to open surgery, and ureteral perforations happened in 8 cases. When these patients were followed-up for 1～6 months after operations, no signs of calculus residue and ureteral stricture were found.[Conclusion]TPL can bring about highly satisfactory effects in the treatment of UC.

关 键 词：输尿管结石/外科学 碎石术 内窥镜检查 

分 类 号：R693.4[医药卫生—泌尿科学]