CAJ | 학술논문

目的：探讨输尿管镜气压弹道碎石术（URSL）治疗输尿管上段结石时B超监测结石漂移的临床价值。方法对40例输尿管上段结石患者行URSL治疗时采用床边B超实时监测术中结石漂移情况。结果原位碎石成功32例（80.0%），结石一次清除23例（57.5%），碎石失败8例（20.0%）。进镜时B超发现结石整枚漂移9例（9/40），其中1例移入肾内；碎石时B超早于输尿管镜发现结石整枚漂移12例（12/36），其中2例移入肾内；结石粉碎后B超发现有结石碎片逆向漂移16例（16/32），其中5例共7枚碎片漂移入肾内，其余漂移碎片最后均被输尿管镜证实并在B超引导下成功清除。结论 URSL治疗输尿管上段结石时，B超监测能早于输尿管镜发现结石漂移，有助于减少结石漂移入肾内的风险。
목적：탐토수뇨관경기압탄도쇄석술（URSL）치료수뇨관상단결석시B초감측결석표이적림상개치。방법대40례수뇨관상단결석환자행URSL치료시채용상변B초실시감측술중결석표이정황。결과원위쇄석성공32례（80.0%），결석일차청제23례（57.5%），쇄석실패8례（20.0%）。진경시B초발현결석정매표이9례（9/40），기중1례이입신내；쇄석시B초조우수뇨관경발현결석정매표이12례（12/36），기중2례이입신내；결석분쇄후B초발현유결석쇄편역향표이16례（16/32），기중5례공7매쇄편표이입신내，기여표이쇄편최후균피수뇨관경증실병재B초인도하성공청제。결론 URSL치료수뇨관상단결석시，B초감측능조우수뇨관경발현결석표이，유조우감소결석표이입신내적풍험。
Objective To evaluate the application of ultrasound- monitoring calculi drifting in transureteroscopic pneu-matic lithotripsy (URSL) for upper ureteral calculi. Methods From January 2010 to December 2012, a total of 40 patients with upper ureteral calculi underwent pneumatic lithotripsy through rigid ureteroscope, and intraoperative drifting stones were moni-tored by bedside ultrasonography(US) in our hospital. Results Among 40 cases of ureteral calculi, rate of successful fragmen-tation in situ was 80.0%(32/40), and the stones were cleared away immediately after a single procedure in 23 patients (57.5%) and 8 patients failed, among whom calculi integral drifted into the kidney pelvis in 3 cases. Before ureteroscope entering ureter and calculi were found, calculi integral drifting were detected by US in 9 patients(9/40). During stones broke, 12 cases with cal-culi integral drifting and 16 cases with calculi debris drifting were detected by US in time, and a total of 7 calculi debrises drifted into the kidney in 5 patients, the others debrises were cleaned away under ultrasound- guidance. Al the drifting stones detected by US were proved by ureteroscope or operation and clinical diagnoses. Conclusion Ultrasound- monitoring can detect calculi drifting sooner than ureteroscope, and can reduce the risk of calculi drifting into the kidney during URSL for upper ureteral cal-culi.