| 摘要: |
| ［摘要］ 目的 总结输尿管镜下气压弹道碎石术治疗输尿管结石失败的原因和处理方法。方法 回顾性分析经尿道输尿管镜下气压弹道碎石术治疗617例(658侧)输尿管结石患者中失败77例的临床资料。结果 单次碎石成功率为88.3%(581/658),失败率为11.7%（77/658）。其中输尿管口狭窄2例,输尿管扭曲狭窄，输尿管镜难以抵达结石23例，改开放手术；结石上移，进入肾盂46例,放置双J管，术后配合ESWL术治疗；输尿管穿孔6例，4例留置双J管术后配合ESWL术治疗，2例改开放手术。结论 输尿管镜下气压弹道碎石治疗输尿管结石疗效可靠，术前合理选择病例，术中仔细操作，提高手术技巧，并配合其他腔内碎石技术，是提高手术成功率的关键。 |
| 关键词: 输尿管结石 输尿管镜 气压弹道碎石术 |
| DOI：10.3969/j.issn.1674-3806.2011.04.23 |
| 分类号:R 693 |
| 基金项目: |
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| Analysis on the cause of failure of ureteroscopic pneumatic lithotripsy and its corresponding countermeasures |
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LI Bao-an, HE Chang-hai, ZHAO Qi
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Department of Urology, the First People′s Hospital of Nanyang City, Henan 473010, China
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| Abstract: |
| ［Abstract］ Objective To summarize the causes of the failure of ureteroscopic pneumatic lithotripsy(URSL) treating ureteral calculus and the corresponding countermeasures.Methods The clinical data of 77 failure cases from 617 cases of ureteral calculus treated by URSL were analyzed retrospectively.Results The success rate of URSL was 88.3% (581/658) after one-time treatment; 77 cases failed, accounting for 11.7%. Among the failure cases, 2 cases were stricture of ureteral orifice, 23 cases were that ureteroscopy can′t touch the stones because of the tortuous or narrow ureters, and these 25 cases ended with open surgery. And in other 46 cases, stones moved up to pelvis, thus double J was placed, combined with the treatment of ESWL after operation. The remaining 6 cases were ureteral perforation: double J was placed combined with the treatment of ESWL after operation in 4 cases, and open surgery were performd in 2 cases.Conclusion URSL is an effective treatment for ureteral calculus. Selecting the proper cases before operation, carefully operating during surgery, improving operating technique, combined with other intracavity lithotripsy are the key to boost surgery′s success rate. |
| Key words: Ureteral calculus Ureteroscopy Pneumatic lithotripsy |
