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目的探讨输尿管镜配合第三代EMS气压弹道联合真空负压吸附碎石清石技术治疗输尿管结石的临床疗效。方法应用输尿管镜配合第三代EMS气压弹道联合真空负压吸附碎石清石技术治疗输尿管结石237例,其中输尿管上段结石39例,输尿管中段结石72例,输尿管下段结石126例,结石最大横径0.5～2.2cm,平均1.32cm。结果 235例行原位碎石,2例上移至肾脏未能行原位碎石,均为输尿管上段结石,原位碎石率为99.2%;7例碎石过程中结石碎片上移至残留,上移率为2.9%,上移结石视结石大小及位置行经皮肾镜技术(PC-NL)或术后体外冲击波碎石术(ESWL)治疗;术中输尿管穿孔1例,术后高热6例,无输尿管撕脱、严重血尿、休克等严重并发症发生,术后随访1～3个月,结石排净率为96.4%。结论输尿管镜气压弹道联合真空负压吸附碎石清石技术治疗输尿管各段结石具有较高的碎石清石率,可有效减少结石上移残留,具有微创、安全、有效等优点,值得临床广泛推广。
Objective To investigate the clinical efficacy of ureteroscope combined with the third generation of EMS pneumatic ballistics combined with vacuum suction gravel lithotripsy in the treatment of ureteral calculi. Methods ureteroscopy combined with the third generation of EMS pneumatic ballistic vacuum suction adsorption gravel stone technology in the treatment of 237 cases of ureteral calculi, of which 39 cases of upper ureteral stones, ureteral stones in 72 cases, 126 cases of lower ureteral calculi, the largest diameter of stones 0.5 ~ 2.2cm, an average of 1.32cm. Results 235 cases were treated with orthotopic gravel, 2 cases were moved up to the kidney, and failed to be treated with orthotic lithotripsy, all of them were upper ureteral calculi, the rate of in-situ lithotripsy was 99.2%. In 7 cases, lithotripsy moved up to the residual (2.9%). The upturned stones were treated by percutaneous nephrolithotomy (PC-NL) or extracorporeal shock wave lithotripsy (ESWL) depending on the size and location of stones. One case of ureter perforation and 6 cases of postoperative fever Cases, no ureteral avulsion, severe hematuria, shock and other serious complications, follow-up 1 to 3 months after operation, the stone clear rate was 96.4%. Conclusions Ureteroscopic pneumatic ballistics combined with vacuum negative pressure adsorption gravel lithotripsy for the treatment of ureteral calculi in every segment of the ureter has a high gravel rate and can effectively reduce the residual migration of the stone with the advantages of minimally invasive, safe and effective, which is worthy of clinical application Extensive promotion.