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目的 探讨输尿管镜气压弹道碎石术治疗输尿管结石的临床效果及并发症预防。 方法 对 36 4例输尿管结石患者采用输尿管镜气压弹道碎石术治疗。 结果 输尿管镜直视下一次操作成功 331例 ,成功率 90 .9% ,4～ 8周内结石全部排净。合并输尿管炎性息肉 6 5例 ,均于术中用异物钳切除。发现输尿管移行细胞原位癌 1例 ,行肾输尿管膀胱袖式切除术。发生并发症 2 1例 ,其中输尿管穿孔 12例 ,采取保守治疗 7例 ,开放手术 5例。随访 1～ 2 1个月未发现输尿管狭窄。泌尿系感染 9例 ,1例术后 1月复查为左肾周脓肿行肾切除术。 结论 输尿管镜气压弹道碎石治疗输尿管结石具有安全性高 ,并发症少 ,有效率高的优点 ,是治疗输尿管结石的有效方法之一。
Objective To investigate the clinical effect and complications of ureteroscopic pneumatic lithotripsy in the treatment of ureteral calculi. Methods 364 patients with ureteral calculi underwent ureteroscopic pneumatic lithotripsy. The results of ureteroscopic operation under the success of a successful 331 cases, the success rate of 90.9%, 4 to 8 weeks all the stones row net. Sixty-five patients with ureteral polyps were surgically removed with foreign body forceps. One case of ureteral transitional cell carcinoma in situ was found, and the kidney ureter bladder sleeve resection was performed. Complications occurred in 21 cases, of which 12 cases of ureter perforation, conservative treatment in 7 cases, 5 cases of open surgery. Ureteral stenosis was not observed in 1 ~ 21 months follow-up. Urinary tract infection in 9 cases, 1 case of January review for left renal abscess nephrectomy. Conclusions Ureteroscopic pneumatic lithotripsy is one of the effective ways to treat ureteral calculi because of its advantages of high safety, less complications and high efficiency.