中华腔镜泌尿外科杂志（电子版）
中華腔鏡泌尿外科雜誌（電子版）
중화강경비뇨외과잡지（전자판）
CHINESE JOURNAL OF ENDOUROLOGY(ELECTRONIC VERSION)
2008年
4期
37-39
,共3页
输尿管镜%气压弹道碎石%输尿管结石%肾积水%肾绞痛
輸尿管鏡%氣壓彈道碎石%輸尿管結石%腎積水%腎絞痛
수뇨관경%기압탄도쇄석%수뇨관결석%신적수%신교통
Ureteroscope%Pneumatic Lithotripsy%Ureteral Calculi%Hydronephrosis%Renal Colic
目的 评价输尿管镜气压弹道碎石术(URSL)治疗输尿管结石的临床疗效.方法 使用输尿管镜下气压弹道碎石术治疗输尿管结石170例,输尿管上段结石10例,输尿管中段结石42例,输尿管下段结石118例,结石最大直径2.2 cm,平均1.0 cm,合并患侧肾积水80例,伴肾绞痛77例,平均病史为24周.结果 一次性碎石成功率90.5%(154例);10例输尿管壁残留小结石,术后1个月复查静脉肾盂造影(IVU),残石已排净;2例较大残余结石上移至肾盂行体外冲击波碎石(ESWL),1个月内结石排净;4例改开放手术, 2例为结石被息肉严重包裹碎石失败,2例结石远端严重狭窄;均无输尿管穿孔、撕裂、假道、撕脱等并发症;随访9～12个月,肾积水病例积水情况明显改善;伴肾绞痛病例症状消失;未见结石复发病例.结论 输尿管镜气压弹道碎石术治疗输尿管结石疗效确切、安全.
目的 評價輸尿管鏡氣壓彈道碎石術(URSL)治療輸尿管結石的臨床療效.方法 使用輸尿管鏡下氣壓彈道碎石術治療輸尿管結石170例,輸尿管上段結石10例,輸尿管中段結石42例,輸尿管下段結石118例,結石最大直徑2.2 cm,平均1.0 cm,閤併患側腎積水80例,伴腎絞痛77例,平均病史為24週.結果 一次性碎石成功率90.5%(154例);10例輸尿管壁殘留小結石,術後1箇月複查靜脈腎盂造影(IVU),殘石已排淨;2例較大殘餘結石上移至腎盂行體外遲擊波碎石(ESWL),1箇月內結石排淨;4例改開放手術, 2例為結石被息肉嚴重包裹碎石失敗,2例結石遠耑嚴重狹窄;均無輸尿管穿孔、撕裂、假道、撕脫等併髮癥;隨訪9～12箇月,腎積水病例積水情況明顯改善;伴腎絞痛病例癥狀消失;未見結石複髮病例.結論 輸尿管鏡氣壓彈道碎石術治療輸尿管結石療效確切、安全.
목적 평개수뇨관경기압탄도쇄석술(URSL)치료수뇨관결석적림상료효.방법 사용수뇨관경하기압탄도쇄석술치료수뇨관결석170례,수뇨관상단결석10례,수뇨관중단결석42례,수뇨관하단결석118례,결석최대직경2.2 cm,평균1.0 cm,합병환측신적수80례,반신교통77례,평균병사위24주.결과 일차성쇄석성공솔90.5%(154례);10례수뇨관벽잔류소결석,술후1개월복사정맥신우조영(IVU),잔석이배정;2례교대잔여결석상이지신우행체외충격파쇄석(ESWL),1개월내결석배정;4례개개방수술, 2례위결석피식육엄중포과쇄석실패,2례결석원단엄중협착;균무수뇨관천공、시렬、가도、시탈등병발증;수방9～12개월,신적수병례적수정황명현개선;반신교통병례증상소실;미견결석복발병례.결론 수뇨관경기압탄도쇄석술치료수뇨관결석료효학절、안전.
Objective To evaluate the clinical efficacy of pneumatic lithotripsy through transurethral rigid ureteroscope for the treatment of ureteral calculi. Methods 170 patients with ureteral calculi underwent pneumatic lithotripsy through ureteroscope.10 patients had calculi in the proximal ureter, 42 patients,in the middle part, 118 patients, in the distal part. The size of stones ranged from 0.6 cm to 2.2 cm in diameter, average was 1.0 cm. There were ipsilateral hydronephrosis in 80 patients, and panyinenal colic in 77 patients. The average period of stones stayed was 24 weeks. Results 154 cases(90.5%) were stone free immediately after the procedures.10 cases had residual fragments on the ureteral wall, which were eliminated and could not be found in IVU one month after the procedures. 2 cases with residual large fragments were shifted to the renal pelvis and treated with ESWL and finally eliminated one month. 2 cases procedure were failed due to polypus packed the stone seriously and converted to open surgery translumbar ureterolithotomy. The procedure failed in 2 cases due to narrow of ureteral distal part which were converted to open surgery translumbar ureterolithotomy. None of 170 cases had complications of ureteral perforation and injury. Accompanying ipsilateral hydronephrosis were decreased. The renal colic of all patients were disappeared. All patients were follow-uped for 9-12 months, no recurrence were observed. Conclusions Pneumatic lithotripsy through rigid transurethral ureteroscope for the treatment of ureteral calculi is effective and safe.
