输尿管镜气压弹道碎石治疗输尿管结石疗效分析  

Clinical analysis of ureteral calculus treated with transurethral ureteroscopic pneumatic lithotripsy

作　　者：庞栋[1] 贺兵[1] 王华[1] 肖序仁[1] 

机构地区：[1]武警总医院泌尿外科,北京100039

出　　处：《武警医学》2010年第12期1038-1040,共3页Medical Journal of the Chinese People's Armed Police Force

摘　　要：目的探讨输尿管镜下气压弹道碎石治疗输尿管上段和中下段结石的安全性、有效性及相关方法。方法回顾分析2006-05至2010-03采用德国WolfF8/9.8输尿管硬镜治疗328例输尿管结石临床资料,对碎石率、排石率和并发症进行统计分析。结果输尿管上、中、下段结石分别为75例、96例、157例。碎石时间15～75 min,平均35 min。输尿管镜一次碎石率94.5%,其中上段89.3%,中段95.8%,下段96.8%。1例改开放手术,16例结石移位至肾盂,留置支架管后辅以ESWL碎石。术中出血量3～15 ml,平均5 m1。术后住院时间3～7 d,平均6.5 d。随访3～15个月,平均8个月,1个月内结石全部排净,未出现输尿管穿孔、狭窄等并发症。结论输尿管镜气压弹道碎石术高效、安全、损伤小,可作为治疗输尿管结石的首选方法。Objective To study the therapeutic efficacy, safety and methods of ureteral calculus treatment using transurethral ureteroscopic pneumatic lithotripsy. Methods A retrospective analysis was made on 328 patients with ureteral calculus treated with TUPL from May 2006 to March 2010. The clinical data, and specifically the stone disintegration rate, lithagogue rate and complications were retrospectively analyzed. The ureteral calculus size was 0.6 cm × 0.8 cm - 1.8 cm ×2.5 cm. Results Among 328 cases of uret- eroscopic pnemnatic lithotripsy for treatment of ureteral stones, the rate of successful fragmentation in a single procedure was 94.5% （311/328）, with 89.3% （67/75）, 95.8% （92/96） and 96.8% （152/157） for the upper, middle and lower levels of ureteral stones, respectively. The stone was pushed back to the renal pelvis in 16 cases and extracorporeal shock wave lithotripsy （ESWL） was needed. The insertion of the ureteroscope failed in 1 case and open surgery was required. The TUPL time was 15 - 75 min （ mean 35 min） and the intraoperative blood loss was 3 - 15 ml （ mean 5 ml）. The length of postoperative hospital stay was 3 - 7 d （ mean 6.5 d）. Follow - up examinations for 3 - 15 months （ mean 8 months） showed stone clearance within 1 month and no ureteral stenosis or ureter Defloration. Conclusions Transurethral ureteroscoDic Dneumatic lithotriDsv for the treatment of ureteral calculus is safe and effective.

关 键 词：输尿管结石 输尿管镜 气压弹道碎石 

分 类 号：R691.4[医药卫生—泌尿科学]