ESWL治疗复杂上尿路结石的临床分析

目的：探讨ESWL治疗复杂上尿路结石的方法。方法：总结自1993年以来行ESWL治疗的所有上尿路结石,对其中较大的肾、输尿管结石、肾鹿角结石及多发性结石的碎石效果进行分析,结合文献对石街的防治和双“J”管的应用进行讨论,结果：ESWL治疗上尿路结石总有效率96．4％,治愈率92．1％,较大肾结石有效率93．9％,治愈率91．5％,石街形成率23．7％,单侧多发结石治愈率95．7％,双侧多发结石治愈率100％。结论：ESWL治疗较大的上尿路结石及多发性结石均有很好的效果。 对鹿角形结石应与其它治疗联合应用,应及时发现并治疗碎石后形成的石街,双“J”管的应用并非必要。

TREATMENT OF CALCULUS OF UPPER URINARY TRACT WITH ESWL

Objective To explore the treatment of complex calculus of upper urinary tract with ESWL.Methods The treatments of calculus of upper urinary tract since 1993 were summarized here.The lithotriptic effects of ESWL on major calculi of kidney and urinary tract,stag horn calculi of kidney and multiple calculi were retrospectively analyzed.The prevention of stone street formed by deposits and the application of double J shaped tubes in literature were also discussed here.Results The total effective rate was 96.4%,the curative rate was 92.1%.The effective rate in treating major caculi of kidney was 93.9%,the curative rate was 91.5%,and the formation rate of stone street was 23.7%.The curative rates of unilateral and bilateral multiple calculi were 95.7% and 100% respectively.Conclusion ESWL had good effect on both the caculi of upper urinary tract and multiple caculi.Combined use of of ESWL and other therapies should be chosen to treat stag horn caculi.The stone street formed after lithotriptic treatment should be discovered as early as possible and treated immediately.The double J shaped tubes seem to be unnecessary in treatments.