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目的:探讨输尿管结石体外冲击波碎石(ESWL)失败后行腔内手术治疗的选择。方法:回顾分析153例输尿管结石ESWL失败后接受腔内手术治疗的患者,其中微创经皮肾镜碎石术(MPCNL)20例,输尿管镜碎石术(URL)133例。结果:20例MPCNL患者碎石成功率100%(20/20);133例URL患者碎石成功率81.2%(108/133),3例中转开放手术取石,22例结石上移或残留而再次行ESWL。结论:对于ESWL失败的输尿管结石,选择腔内手术是安全而有效的治疗手段,适应症的掌握、手术方式及时机的选择是治疗成功的关键。
Objective: To investigate the choice of endovascular surgery after failure of extracorporeal shock wave lithotripsy (ESWL) of ureteral calculi. Methods: A retrospective analysis of 153 patients who underwent endoscopic surgery after failure of ESWL for ureteral calculi was retrospectively analyzed. Twenty patients underwent minimally invasive percutaneous nephrolithotomy (MPCNL) and 133 underwent ureteroscopic lithotripsy (URL). Results: The success rate of lithotripsy in 20 patients with MPCNL was 100% (20/20). The success rate of lithotripsy in 133 patients with URL was 81.2% (108/133). Three patients underwent open surgery and 22 patients had stones moved up or remained. Line ESWL. Conclusion: For the failure of ESWL ureteral calculi, the choice of endovascular surgery is a safe and effective treatment, indications of mastery, surgical methods and the timing of the key to the success of the treatment.