[1]田晓军,肖春雷,马潞林,等.输尿管镜下气压弹道碎石治疗输尿管结石[J].中国微创外科杂志,2007,07(8):733-734.
　Tian Xiaojun,Xiao Chunlei,Ma Lulin,et al.Ureteroscopic Pneumatic Lithotripsy for Ureteral Lithiasis[J].Chinese Journal of Minimally Invasive Surgery,2007,07(8):733-734.
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输尿管镜下气压弹道碎石治疗输尿管结石()
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《中国微创外科杂志》[ISSN:1009-6604/CN:11-4526/R]

卷:
07
期数:
2007年8期
页码:
733-734
栏目:
出版日期:
2007-08-20

文章信息/Info

Title:
Ureteroscopic Pneumatic Lithotripsy for Ureteral Lithiasis
作者:
田晓军; 肖春雷; 马潞林; 卢剑; 洪锴; 黄毅; 庄申榕
北京大学第三医院泌尿外科, 北京100083
Author(s):
Tian Xiaojun;  Xiao Chunlei;  Ma Lulin;  et al.
Department of Urology, Peking University Third Hospital, Beijing 100083, China
关键词:
输尿管镜; 气压弹道碎石; 输尿管结石; 碎石术
Keywords:
Ureteroscopy; Pneumatic ballistic; Ureteral calculus; Lithotripsy
分类号:
R693+.4
文献标志码:
A
摘要:
目的探讨输尿管镜下气压弹道碎石治疗输尿管结石的治疗效果。方法我院2002年8月～2006年4月采用Wolf F8/9.8硬性输尿管镜联合瑞士EMS气压弹道碎石机碎石治疗输尿管结石158例163侧。采用椎管内麻醉，生理盐水作为冲洗液，输尿管镜进入输尿管，到达结石处后，气压弹道击碎并取出结石，并上行观察输尿管全长，术后留置双J管引流。结果手术时间15～90 min，平均40 min。碎石成功率96.9％（158/163），其中输尿管上段结石碎石成功率86.6%（13/15），中段结石碎石成功率96.9%（46/49），下段结石碎石成功率100%（99/99）；2例输尿管上段结石移位至肾盂内，留置双J管后行体外冲击波碎石，其余3例为结石被击碎后，残余小结石进入肾盂，留置双J管后行药物排石或体外冲击波碎石。术中出现输尿管穿孔3例（1.8％），留置双J管引流后治愈；无输尿管粘膜撕脱、断裂、周围血管脏器损伤等严重并发症，无中转开放手术。125例随访1～38个月，平均15个月，B超或KUB检查，无结石复发。结论输尿管镜下气压弹道碎石具有碎石成功率高，创伤小，手术时间较短等优点，是治疗输尿管结石的一种安全、有效的方法。
Abstract:
ObjectiveTo evaluate the curative effectiveness of ureteroscopic pneumatic lithotripsy in the treatment of ureteral lithiasis.MethodsUreteroscopic pneumatic lithotripsy was performed in 158 cases of ureteral calculi (163 sides) by using the Wolf F8/9.8 rigid ureteroscope and the EMS pneumatic ballistic lithotriptor from August 2002 to April 2006. The operation was carried out under intravertebral anesthesia. Under the irrigation with normal saline, the ureteroscope was advanced into the ureter. Then the ureteral stones were fragmented by pneumatic lithotripsy and removed. Afterwards, a further exploration of the ureter above the lesion was conducted and a doubleJ drainage tube was placed.ResultsThe operation time was 15-90 min (mean, 40 min). The total successful fragmentation rate was 96.9% (158/163), involving a success rate of 86.6% (13/15) for upper stones, 96.9% (46/49) for middle stones, and 100% (99/99) for lower stones. The stone migration into the renal pelvis was encountered in 2 cases of upper ureteral calculi (treated by extracorporeal shock wave lithotripsy following a doubleJ tube placement) and in 3 cases after stone fragmentation (treated by stone expulsion with drugs or extracorporeal shock wave lithotripsy following a doubleJ tube placement). Ureteral perforation happened during the procedure in 3 cases (1.8%), requiring a doubleJ tube placement. No serious complications occurred, such as ureteral mucous avulsion or rupture and injuries of neighboring organs or vessels. No conversion to open surgery was required. Followup checkups for 1-38 months in 125 cases with Bultrasonography or KUB film found no recurrence.Conclusions Ureteroscopic pneumatic lithotripsy is a safe, effective, and feasible technique for ureteral lithiasis.

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更新日期/Last Update: 2013-12-09