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目的探讨输尿管镜下气压弹道碎石术治疗输尿管结石的疗效并进行经验总结。方法回顾性分析太和县人民医院2007年6月—2013年5月218例接受输尿管镜下气压弹道碎石术的输尿管结石患者临床及随访资料,病例中男性121例,女性97例,中位年龄41岁。其中上段输尿管结石18例,中、下段输尿管结石200例,有10例系肾结石行ESWL术后形成的输尿管石街,并分析总结临床经验。结果本组一次性碎石成功率93.1%(203/218),其中上段83.3%(15/18),中下段94.0%(188/200)。主要并发症为置镜失败(7例)、结石或碎块游入肾盂(8例)和输尿管穿孔(4例)。对193例术后成功随访了1~18个月,平均8.5个月,均未见明显的输尿管狭窄发生。结论输尿管镜下气压弹道碎石术治疗输尿管结石微创、安全、有效。成功置入输尿管镜、妥善处理结石息肉包裹和防止结石游走是提高碎石成功率的关键。
Objective To investigate the efficacy of ureteroscopic pneumatic lithotripsy in the treatment of ureteral calculi and to summarize the experience. Methods The clinical and follow-up data of 218 patients with ureteral calculi undergoing ureteroscopic pneumatic lithotripsy from June 2007 to May 2013 in Taihe People’s Hospital were retrospectively analyzed. Among them, 121 were male and 97 were female, with median Age 41 years old. The upper ureteral calculi in 18 cases, the middle and lower ureteral calculi in 200 cases, 10 cases of renal stones ESWL ureteral stone street formed and analysis of clinical experience. Results The success rate of one-off gravis in this group was 93.1% (203/218), with 83.3% (15/18) in the upper part and 94.0% (188/200) in the lower part. The main complication was placement failure (n = 7), stones or fragments touring the renal pelvis (n = 8) and ureter perforation (n = 4). 193 cases were followed up successfully for 1 to 18 months, an average of 8.5 months, no significant ureteral stricture occurred. Conclusion ureteroscopic pneumatic lithotripsy for ureteral calculi minimally invasive, safe and effective. Successful placement of ureteroscope, proper treatment of stone polyps and prevent stone walking is the key to improving the success rate of gravel.