输尿管结石ESWL失败后腔内手术治疗的选择  

The choice of endoscopic surgery after the failure of ESWL in treating ureteral calculi

作　　者：孙毅海[1] 苏小壮[1] 陶卫琦[1] 刘昕[1] 黄才胜[1] 黄超斌[1] 

机构地区：[1]广西医科大学第三附属医院泌尿外科,南宁530031

出　　处：《临床泌尿外科杂志》2012年第4期289-290,293,共3页Journal of Clinical Urology

摘　　要：目的:探讨输尿管结石体外冲击波碎石(ESWL)失败后行腔内手术治疗的选择。方法:回顾分析153例输尿管结石ESWL失败后接受腔内手术治疗的患者,其中微创经皮肾镜碎石术(MPCNL)20例,输尿管镜碎石术(URL)133例。结果:20例MPCNL患者碎石成功率100%(20/20);133例URL患者碎石成功率81.2%(108/133),3例中转开放手术取石,22例结石上移或残留而再次行ESWL。结论:对于ESWL失败的输尿管结石,选择腔内手术是安全而有效的治疗手段,适应症的掌握、手术方式及时机的选择是治疗成功的关键。Objective：TO investigate the choice of endoscopic surgery after the failure of extracorporeal shock- wave lithotripsy （ESWL） in treating ureteral calculi. Method：One hunder and fifty-three patients with ureteral cal- culi underwent endoscopic surgery after the failure ESWL were discussed retrospectively. 20 patients underwent minimally percutaneous nephrolithotomy（MPCNL）, and 133 patients underwent ureteroscopic lithotripsy（URL）. Result：The success rate of fragmentation were 100% in MPCNL group（20~20）; and 81.2~ in URL group（108/ 133）. There were 3 cases converted to open surgery, and 22 cases underwent ESWL again in URL group. Conclu- sion：The endoscopic surgery is safe and effective for the failure of ESWL in treating ureter calculi. The indica- tions, opportunity and manner of operation are the keys of successful treatments.

关 键 词：输尿管结石 体外冲击波碎石 微创经皮肾镜取石术 输尿管镜碎石术 

分 类 号：R693[医药卫生—泌尿科学]