体外冲击波碎石治疗输尿管结石失败原因与处理  

Causes of Extracorporeal Shock Wave lithotrips failure for ureteral calculi and treatment

作　　者：刘红艳[1] 黄赤龙[1] 

机构地区：[1]暨南大学附属第二医院广东省深圳市人民医院泌尿外科,广东518020

出　　处：《国际泌尿系统杂志》2009年第5期590-591,共2页International Journal of Urology and Nephrology

摘　　要：目的探讨体外冲击波碎石（ESWL）原位治疗输尿管结石失败的原因与处理措施。方法分析25例输尿管结石ESWL原位治疗失败的临床资料。结果25例中，6例改腹腔镜输尿管切开取石术，16例改输尿管镜弹道碎石术，3例改弹道术后因少量碎石滑至肾脏又补充行ESWL治疗，均治愈。术中证实输尿管炎性狭窄3例，息肉18例，肉芽组织包裹4例。结论ESWL治疗输尿管结石疗效可靠，但要正确掌握好适应证。ESWL治疗失败后，输尿管上段结石首选腹腔镜输尿管切开取石术，输尿管下段结石首选输尿管镜下弹道碎石术。Objectives To explore the causes of Extracorporeal Shock Wave lithotrips （ESWL） failure for ureteral calculi and the methods of dealingwith. Methods Analysis was made on 25 cases of ureteral calculi failure with ESWL. Results In the 25 cases, laparoscopic ureterelithotomy was made in 6 cases, swiss lithoclast under ureterescope was made in 16 cases,Another ESWL was made in 3 cases because of the failures of ureterocystoscope with holmium and then some smashed calculus were slided to the kiney. Ureterelithotomy or Ureterocystoseope with holmium revealed that adhesive ureterestenosis in 3, inflammatory ureteral polyp in 18, encapsulation of the calculi by granulation tissue in 4. Conclusions ESWL is a good way to treat ureteral calculi for its dependability, but it only can be used in indication. Laparoscopic ureterelithotomy is the best way for upper segment ureteral calculi and swiss lithoclast under ureteroscope is the best way for middle or lower segment ureteral calculi when ESWL fails.

关 键 词：输尿管结石 碎石术 

分 类 号：R699.4[医药卫生—泌尿科学]