嵌顿性输尿管结石的微创治疗  

Minimally Invasive Treatment for Ureteral Calculus Accompanied with Granulation:27 Cases Report

作　　者：庞栋[1] 贺兵[1] 贾永中 王华[1] 肖序仁[1] 

机构地区：[1]武警总医院泌尿外科,北京市100039

出　　处：《中国康复理论与实践》2010年第9期869-871,共3页Chinese Journal of Rehabilitation Theory and Practice

摘　　要：目的探讨嵌顿性输尿管结石采用输尿管镜下2μm激光联合气压弹道碎石治疗的安全性、有效性。方法对27例(30侧)嵌顿性输尿管结石患者进行回顾性分析。结果 28例侧原位碎石成功。碎石时间15～45min,平均25min;术中出血量3～15ml,平均5ml。术后住院时间3～7d,平均5.5d。1例上段结石上移至肾盂,留置支架管后辅以体外冲击波碎石;1例输尿管狭窄置镜失败。随访3～15个月,平均8个月。术后1个月,26例侧结石排净,4例侧残石存在;未出现输尿管狭窄、尿路感染等并发症。结论输尿管镜下2μm激光联合气压弹道碎石治疗嵌顿性输尿管结石安全、高效。Objective To investigate the therapeutic effects,safety of pneumatic lithotripsy and 2 μm laser via transurethral ureteroscope for ureteral calculi accompanied with granulation.Methods27 cases（30 sides）of ureteral calculi accompanied with granulation treated with 2 μm laser and pneumatic lithotripsy via ureteroscope were reviewed.Results28 sides were fragmented successfully in a single procedure.The operation time was 15~45 min（mean 25 min）.The intraoperative blood loss was 3~15 ml（mean 5 ml）.The postoperative hospitalization time was 3~7 d（mean 5.5 d）.1 upper ureteral stone was pushed back to the renal pelvis and extracorporeal shock wave lithotripsy was needed.The insertion of the ureteroscope was failed in 1 cases,who accepted open operation finally.Double-J tubes were pulled out in all the patients after 1 month,and 26 sides were stone-free.They were followed-up for 3~15 months（mean 8 months）,no ureteral stenosis or urinary infection was found.Conclusion2 μm laser and pneumatic lithotripsy via ureteroscope is an effective and safe therapy for ureteral calculi with granulation,especially for those on middle or lower levels.

关 键 词：输尿管结石 输尿管镜 2ΜM激光 气压弹道碎石 

分 类 号：R693[医药卫生—泌尿科学]