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目的:观察急诊行经尿道输尿管镜碎石术治疗输尿管结石患者的安全性及有效性。方法:2009年3月~2013年4月,对60例因输尿管结石导致急性肾绞痛患者急诊于硬膜外麻醉下行经尿道输尿管镜碎石术。结果:60例患者,输尿管上段结石中2例在碎石过程中结石移位至肾盂而联合输尿管软镜治疗,余患者均采用半硬性输尿管镜手术成功,结石清除率月96.7%,住院时间平均为3天,术后7天门诊拔出输尿管支架管,4例术前肌酐水平高于正常者于术后2~3周拔出输尿管支架管,随访6个月无远期并发症发生。结论:因输尿管结石而造成急性肾绞痛患者,急诊硬膜外麻醉下行经尿道输尿管镜碎石术能够快速解除患者痛苦,保护肾功能,无明显不良反应发生,为一种安全、有效的治疗手段。
Objective: To observe the safety and effectiveness of emergency urethral ureteroscopic lithotripsy in patients with ureteral calculi. Methods: From March 2009 to April 2013, transurethral ureteroscopic lithotripsy was performed under epidural anesthesia in 60 emergency patients with acute renal colic caused by ureteral calculi. Results: In 60 patients, 2 cases of upper ureteral calculi in the lithotripsy moved to the renal pelvis combined with ureteroscopic soft lens therapy, the remaining patients were treated by semi-rigid ureteroscopic operation, the stone removal rate was 96.7%, average length of stay For 3 days, ureteral stent was withdrawn from clinic at 7 days postoperatively, 4 cases with preoperative serum creatinine level higher than normal were removed ureteral stent tube 2 to 3 weeks after operation. There was no long-term complication after 6 months follow-up. Conclusion: Transurethral ureteroscopic lithotripsy in emergency patients with acute renal colic caused by ureteral calculi can relieve pain and protect renal function rapidly without any adverse reactions, which is a safe and effective treatment means.