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目的:分析输尿管结石多次体外冲击波碎石治疗无效的原因。方法:输尿管结石经多次冲击波碎石后无效患者128例,观察其治疗全过程、分析影响疗效的因素。结果:128例经多次冲击波碎石后只有少量碎石或无碎石排出,经后续泌尿外科腔镜或开放手术治疗,术中发现结石嵌顿息肉包裹93例,结石远端梗阻扭曲35例。结石成分分析显示为硬度较高的草酸钙、磷酸钙81例。结论:多次碎石无效的原因有:结石嵌顿息肉、结石较大及较多、远端梗阻,结石密度高等,同时存在2个以上因素者尤其明显,临床上这类患者宜早期采用其他治疗方法。
OBJECTIVE: To analyze the causes of multiple extracorporeal shock wave lithotripsy of ureteral calculi. Methods: 128 cases of ureteral calculi invalid after multiple shock wave lithotripsy were observed the whole process of treatment, analysis of the factors that affect the efficacy. Results: 128 cases of multiple shock wave lithotripsy after only a small amount of gravel or no lithotripsy discharged by the follow-up urology endoscopic or open surgery, intraoperative findings of stone incarcerated polyps wrapped 93 cases of stones distal obstruction distorted in 35 cases . Stone composition analysis showed a higher hardness of calcium oxalate, calcium phosphate in 81 cases. Conclusion: The causes of multiple invalid stones are: stone incarcerated polyps, larger and more stones, distal obstruction, high stone density, especially in the presence of more than two factors, such patients should be clinically early use of other treatment method.