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目的探讨输尿管镜下气压弹道碎石术(URSI)治疗输尿管结石失败的相关因素。方法:对本院2011年3月～2012年6月期间应用输尿管镜下气压弹道碎石术治疗输尿管结石失败的病历进行回顾性分析。结果:本组66例患者,失败11例,其中4例找不到输尿管开口置镜失败而放弃,3例输尿管局部狭窄,2例结石上移至肾盂均留置双J管后经ESWL治疗痊愈;1例输尿管迂曲或狭窄致进镜困难,无法窥见结石;1例输尿管穿孔。结论结石上移肾盂、输尿管扭曲、输尿管炎性息肉形成后狭窄、输尿管开口异常是输尿管镜下气压弹道碎石失败的常见原因,而手术中操作者的技术水平、操作熟练程度、冲洗速度及术前选择合适病例对手术成功至关重要。
Objective To investigate the related factors of the failure of ureteroscopic pneumatic lithotripsy (URSI) in the treatment of ureteral calculi. Methods: The hospital records from March 2011 to June 2012 during the application of ureteroscopic pneumatic lithotripsy for the treatment of ureteral calculi were retrospectively analyzed. Results: Sixty - six patients in this group failed in 11 cases, of which 4 cases failed to find ureteropelvic mirror failure, 3 cases had ureteral stricture, 2 cases moved to renal pelvis with double J tube and were cured by ESWL. One case of ureter tortuous or narrow into the mirror into the difficulties, can not see the stones; 1 case of ureter perforation. Conclusions The renal pelvis and ureter distorted after ureteral calculi, and the narrow ureter polyps formed. The abnormal ureter opening is a common cause of failure of pneumatic lithotripsy under ureteroscopy. The technical level, operating proficiency, rinsing speed and operation Choosing the right case before is crucial to the success of the procedure.