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目的探讨输尿管镜治疗顽固性肾绞痛的临床疗效。方法选择2010年10月～2013年2月来我院治疗的顽固性肾绞痛患者48例,其中男性29例,女性19例,采用腰硬联合麻醉,直径2～3mm结石异物钳直接取出,>3mm结石用气压弹道碎石后用异物钳取出,常规放置双J管3～4周。结果输尿管镜下发现输尿管下段结石26例,中段结石11例,上段结石8例,絮状物2例,血凝块1例,其中输尿管结石伴狭窄4例,输尿管结石伴息肉3例。术后疼痛完全消失42例,疼痛明显缓解6例,可暂停使用镇痛药物。结论输尿管镜治疗不仅可以在比较短的时间内检查出肾绞痛的病因,还可以依照病因采取不同的治疗手段,是一种治疗顽固性肾绞痛安全、便捷的诊断及治疗方法。
Objective To investigate the clinical efficacy of ureteroscopic treatment of refractory renal colic. Methods Forty-eight patients with refractory renal colic who were treated in our hospital from October 2010 to February 2013 were selected, including 29 males and 19 females. The patients were treated with combined spinal-epidural anesthesia and 2 ~ > 3mm stones with pneumatic lithotripsy with foreign body forceps removed, the conventional double J tube placed 3 to 4 weeks. Results Ureteroscopy revealed 26 cases of lower ureteral stones, 11 cases of middle stones, 8 cases of upper stones, 2 cases of floccules and 1 case of blood clots. There were 4 ureteral calculi with stenosis and 3 cases of ureteral calculi with polyp. Postoperative pain disappeared completely in 42 cases, 6 cases of pain relief, can be suspended using analgesics. Conclusion Ureteroscopy can not only detect the cause of renal colic in a relatively short period of time, but also take different treatment according to the cause. It is a safe and convenient method for diagnosis and treatment of refractory renal colic.