输尿管镜气压弹道碎石术治疗输尿管结石221例

目的探讨输尿管镜气压弹道碎石术治疗输尿管结石的效果。方法2003年1月～2007年6月，对输尿管结石221例，采用单腿截石位（架健侧腿患侧下肢平放外展），在腰麻硬膜外联合麻醉下行输尿管镜气压弹道碎石术，碎石取石后常规留置双J管作为支架引流。结果221例手术时间15～118min，平均55min。结石位于上段16例、中段52例、下段153例，228枚结石均原位粉碎，碎石成功率100％，术中结石排净率为95．5％（211／221），7例碎石不满意及3例伴同侧肾结石者术后ESWL治愈。189例随访3～6个月，无结石残留及复发。结论输尿管镜气压弹道碎石术治疗输尿管结石创伤小、疗效好，术后联合ESWL术可以提高结石清除率，是一种可供选择的治疗方式。

Ureteroscopic Pneumatic Lithotripsy for Ureteric Calculi: Report of 221 Cases

Objective To evaluate the efficacy of ureteroscopic pneumatic lithotripsy for ureteric calculi. Methods From January 2003 to June 2007, 221 patients with ureteric calculi underwent ureteroscopic pneumatic lithotripsy in our hospital. Under continuous epidural anesthesia combined with spinal anesthesia, the surgery was performed in lateral lithotomy position. Double-J catheter was used for drainage after the operation. Results The mean operation time was 55 minutes （ranged from 15 to 118 minutes）. Among the patients, the calculi were found in the upper ureter in 16 cases, middle segment in 52 cases, and lower ureter in 153 cases. A total of 228 stones in the 211 patients were all fragmented with a success rate of 100% . The discharging rate was 95.5% （211/221）. ESWL was used in 7 cases with unsatisfied outcomes and 3 patients who had ipsilateral renal calculi. A 3- to 6-month follow-up was achieved in 189 of the patients, who had no recurrence during the period. Conclusions Ureteroscopic pneumatic lithotripsy is a minimal invasive and effective treatment for ureteric calculi. Postoperative ESWL is an alternative which can increase the rate of stone clearance.