仰卧位ESWL治疗后尿道结石的疗效观察

目的：提高体外冲击波碎石术(ESWL)治疗后尿道结石的治疗方法。方法：61例后尿道结石患者随机分为A、B两组，A组(29例)采用仰卧位ESWL治疗，B组(32例)将后尿道结石推至膀胱内行ESWL治疗。结果：经1次ESWL，A组28例(96．5％)结石全部排出，余1例1周后行第2次碎石，结石完全排出。术后肉眼血尿16例，程度轻。B组30例(93．7％)1次ESWL术后结石全部排出，余2例1周后行第2次碎石，结石完全排出。术后肉眼血尿31例，较A组严重，1例出现后尿道狭窄，定期尿道扩张治愈。A组疗效与B组相近，副作用比B组低。结论：仰卧位ESWL治疗后尿道结石，能有效地将结石击碎，迅速解除尿道梗阻。并发症少，疗效较好，是后尿道结石碎石的有效方法之一，可在临床推广。

The Observation on Therapeutic Effect of Extracorporeal Shock Wave Lithotripsy in Posterial Urethral Stones with Supine Position

Objective: The aim of the study is to explore the clinical therapeutic method of extracorporeal shock wave lithotripsy( ESWL) in patients with posterial urethral stones.Methods: 61 in patients with posterial urethral stones were randomly allocated to 2 groups (A,B group). A group (29 cases) underwent ESWL with supine position;B group (32 cases) underwent ESWL after pushing the stones into bladder. Results: In A group: all posterial urethral stones were discharged after the first ESWL in 28 patients (96%) , one case needed the second ESWL to discharge all posterial urethral stones after one weeks . 16 cases occurred slightly gross hematuria after ESWL. In B group, all posterial urethral stones were discharged after the first ESWL in 30 patients (93.7%) ,two cases needed the second ESWL to discharge all posterial urethral stones after one weeks . 30 cases occurred significant gross hematuria after ESWL, one case occurred posterial urethrostenosis , and fully recovered after regular urethral sounding , the therapeutic effect closed to each other , and the side effects in A group were lower than that in B group.Conclusions: The ESWL with supine position in patients with posterial urethral stones can effective crash the urethral stones and relief urethremphraxis with fewer complication and signifcant therapeutic effect, the method of extracorporeal shock wave lithotripsy( ESWL) with supine position is one kind of effective method in treating posterial urethral stones and can be generalized to clinical application.