输尿管镜气压弹道碎石治疗小儿输尿管结石体会

目的　探讨输尿管镜气压弹道碎石治疗小儿输尿管结石的效果及并发症。方法　对 10例小儿输尿管中下段结石进行输尿管镜气压弹道碎石。结果　 9例碎石成功并完全排出结石 ,1例未成功 ,1例发生输尿管损伤。结论　输尿管镜气压弹道碎石在操作熟练情况下是治疗小儿输尿管下段结石的理想方法。     

输尿管硬镜气压弹道碎石治疗输尿管结石疗效分析

目的探讨输尿管硬镜气压弹道碎石治疗输尿管结石的疗效。方法采用输尿管硬镜气压弹道碎石治疗输尿管结石共185例200侧。结石位于输尿管上段22侧，中段37侧，下段141侧。结果输尿管上段、中段、下段结石碎石成功率分别为45．4％、81．1％、97．2％。手术并发症发生率为1．5％。结论输尿管硬镜气压弹道碎石治疗输尿管中下段结石安全有效，损伤小，可作为治疗输尿管中下段结石的首选方法。     

输尿管镜气压弹道碎石术治疗输尿管结石68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：对68例输尿管结石患者行输尿管镜气压弹道碎石治疗,观察对各段输尿管碎石的成功率。结果：输尿管镜一次碎石率91.2%,其中上段66.6%,中段80%,下段100%。结论：输尿管镜气压弹道碎石术高效、安全、损伤小,可作为治疗输尿管中下段结石的首选方法。     

输尿管镜气压弹道碎石术治疗输尿管结石(附665例报告)

目的探讨输尿管镜下气压弹道碎石术治疗输尿管结石的疗效。方法采用输尿管镜下气压弹道碎石术治疗输尿管结石665例。结果一次性碎石成功率97.3%（647/665）。术中并发症发生率0.2%（1/665）。结论输尿管镜下气压弹道碎石术较安全，疗效确切，损伤小，可作为治疗输尿管中下段结石的首选方法。     

输尿管镜气压弹道碎石术的疗效分析：附380例报告

目的探讨输尿管镜气压弹道碎石取石术治疗输尿管结石的疗效。方法回顾性分析我院自2006年7月至2011年1月应用输尿管镜气压弹道碎石取石术治疗输尿管结石380例的临床资料。结果手术时间24．5±14．6min,气压弹道平均碎石时间15min。365例输尿管镜下气压弹道碎石取石成功,占96．1％（365/380）,随访1～3个月,结石排净率为97．8％（357/365）,13例患者因输尿管下段狭窄或输尿管扭曲无法进入输尿管镜。56例合并息肉或肉芽包裹的结石患者均用气压弹道成功处理。术后发热25例次,5例术后出现不明原因低血压。术后长期随访未见明显并发症。结论输尿管镜气压弹道碎石术是治疗输尿管中下段结石的一种安全、高效、微创手术,对体外冲击波碎石失败和合并输尿管息肉患者为首选。熟练、耐心、轻柔、准确的输尿管镜操作有助于减少并发症的发生。     

输尿管镜下气压弹道碎石术治疗输尿管结石(附81例报告)

目的　探讨输尿管镜下气压弹道碎石术治疗输尿管结石的疗效。方法　对 81 例输尿管结石患者采用输尿管镜下气压弹道碎石术治疗。结果　一次性碎石成功率为 85.19%,其中输尿管上段结石为 57.14%(4/7),输尿管中段结石为 87.10%(27/31),输尿管下段结石为93.02%(40/43)。结论　输尿管镜下气压弹道碎石术治疗输尿管结石安全有效,创伤小,是治疗输尿管中下段结石的首选方法。     

输尿管镜气压弹道碎石加超声碎石取石术治疗输尿管结石

目的:评价经输尿管镜下气压弹道联合超声碎石术治疗输尿管结石的临床效果和碎石优势.方法:输尿管中、下段结石13例,左侧和右侧各6例,双侧输尿管结石1例(为女性患者),男性8例,女性5例,行输尿管镜下气压弹道联合超声碎石术.结果:13例患者结石全部粉碎,12例结石一次性取净,1例残余小结石.无输尿管损伤、输尿管"石街"等并发症发生.结论:经输尿管镜下气压弹道联合超声碎石术治疗输尿管结石安全、高效,并且容易操作,在碎石的同时就可将结石颗粒吸出,是输尿管中下段结石的首选治疗方法.     

输尿管镜气压弹道治疗输尿管结石260例临床分析

目的 探讨输尿管镜气压弹道碎石术治疗输尿管结石的疗效.方法 回顾性分析2006年10月～2012年10月260例输尿管结石采用输尿管镜联合气压弹道碎石术治疗的临床疗效.结果 244例碎石成功或取出,成功率93.8％.其中上段结石成功率75.9％(41/54),中下段为98.5％(203/206).25例进镜困难,采用镜体旋转、变换角度,经扩张以及调整体位后入镜成功.13例结石上移入肾盂,置入双J管后行体外冲击波碎石术.3例因严重输尿管狭窄转开放手术.结论 输尿管镜联合气压弹道碎石治疗输尿管结石手术效果好,尤其是中下段结石,对于输尿管镜进镜困难,需要一定技术要求,必要时改开放手术.     

输尿管镜下气压弹道碎石术治疗输尿管结石175例报告

目的:探讨输尿管镜下气压弹道碎石术治疗输尿管结石的疗效。方法:采用输尿管镜下气压弹道碎石术治疗输尿管结石175例190侧。结果:一次性碎石成功率96.0%(168/175),1周内结石排净率94.0%(178/190)。术中并发症发生率4%(11/175)。结论:输尿管镜下气压弹道碎石术较安全,疗效确切,损伤小,可作为治疗输尿管中下段结石的首选方法。     

输尿管结石ESWL治疗失败后输尿管镜下治疗

目的探讨输尿管结石体外冲击波碎石(extracorporeal shock wave lithotripsy,ESWL)治疗失败后输尿管镜下治疗的效果. 方法 23例输尿管结石ESWL治疗失败后,在输尿管镜下通过气压弹道碎石机配合自制输尿管镜针状电刀分别进行碎石、取石、息肉切除术. 结果 2例结石已被粉碎,但被息肉组织紧紧包裹,钳夹息肉将结石取出;16例结石部分粉碎,气压弹道碎石、取石;4例结石完好,与输尿管壁及息肉粘连,用自制输尿管镜针状电刀切除息肉,将结石粉碎取出;1例结石部分嵌入到输尿管黏膜下,致使结石难以排出,用自制输尿管镜针状电刀切开结石表面黏膜后,粉碎结石取出.手术时间30～55 min,平均42 min.术后6个月复查未见结石残留. 结论输尿管结石ESWL治疗失败的病人可以通过输尿管镜气压弹道碎石配合自制输尿管镜针状电刀切开达到治疗目的.     

输尿管镜下气压弹道碎石术(附43例报告)

目的　研究输尿管镜下气压弹道碎石术治疗输尿管结石的方法及并发症的防治。　方法　回顾分析输尿管镜下气压弹道碎石术治疗输尿管结石 43例的临床资料。　结果　一次性碎石成功率 93 0 % (4 0 / 43 ) ,7d内结石排净率 93 0 % (4 0 / 43 )。未发生并发症。　结论　输尿管镜下气压弹道碎石方法较安全 ,疗效确切     

急诊输尿管镜治疗输尿管结石并顽固性肾绞痛的应用价值

目的：探讨急诊输抹管镜下取（碎）石术瀹疗输尿管结石外顽剧性肾绞痛的临床应用价值。方法：采用急诊输尿管镜下取（碎）白术治疗输尿管结石并顽固性肾绞痛患者300例,其中上段结石35例,中段结石87例,下段结石178例。较小结石用取石钳取出,较大者用气压弹道碎石。结果：上、中、下段结石治疗成功率分别为74．3％、95．4％、97．75％;未出现输尿管黏膜撕脱、断裂、菌血症等严重并发症。结论：急诊输尿管镜下治疗输尿管结石并顽固性肾绞痛安全有效,损伤小,可作为首选方法之一。     

双J管在输尿管镜气压弹道碎石术中的临床应用

目的探讨双J管在输尿管镜气压弹道碎石术治疗泌尿系结石中的临床疗效。方法自1999年11月至2003年11月,采用输尿管镜下气压弹道碎石术治疗输尿管结石546例,术后16例未留置任何支架管引流,其他患者留置双J管或输尿管导管。结果留置双J管的451例患者术后无一例出现并发症,留置输尿管导管并发症发生率为22．7％（18／79）,未留置任何导管并发症发生率为56．2％（9／16）,主要是肾绞痛及急性肾盂肾炎、血尿。结论输尿管镜术后常规留置双J管可明显减少术后并发症的发生。     

输尿管镜下NTrap拦截网配合超声弹道碎石治疗输尿管上段结石

目的探讨输尿管镜下NTrap拦截网配合超声弹道碎石治疗输尿管上段结石的临床疗效。方法采用输尿管镜下NTrap拦截网配合第三代超声弹道碎石系统治疗输尿管上段结石20例。结石横径为5～13mm，纵径为6～20mm。其中9例先采用钬激光将结石适当打碎后再采用三代超声碎石。结果所有结石都被拦截网固定后碎石，一次性碎石成功率95％（19／20），1例术后结合体外冲击波碎石（ESWL）治愈；平均手术时间46min；估计术中平均失血量为10mL。术中无1例输尿管穿孔和明显的出血。结论拦截网将结石适当固定是碎石成功的关键，与第三代超声弹道碎石清石系统联合应用具有结石清除率高、创伤小、并发症少等特点，是值得临床推荐的一种治疗方法。     

输尿管中下段结石并感染的内镜治疗

目的:探讨输尿管中下段结石并感染的内镜治疗方法.方法:回顾性分析33例输尿管中下段结石并感染患者的临床资料,采用一期导管旁输尿管镜气压弹道碎石术治疗21例;先期行经皮肾造瘘,二期行输尿管镜碎石取石术12例.结果:施行一期输尿管镜碎石术的21例患者中,2例术中改为经皮肾穿刺造瘘,2例术后出现不同程度的发热和肾区胀痛.施行经皮肾造瘘后二期输尿管镜碎石取石术的12例患者中,无一例术后出现发热及肾区胀痛.结论:对于输尿管中下段结石并感染患者,如血常规正常、肾积水较轻且B超透声好、体温正常,可行导管旁输尿管镜气压弹道碎石术;而对于血常规指标高、肾积水重且B超透声差、伴发热者,应先期行经皮肾造瘘,二期行输尿管镜碎石取石术.     

气压弹道碎石联合ESWL治疗输尿管中下段结石

目的：探讨气压弹道碎石联合体外冲击波碎石术（ESWL）治疗输尿管中下段结石的临床疗效。方法：采用气压弹道碎石联合ESWL治疗输尿管中下段结石188例。结果：188例中,185例碎石成功,2例碎石失败,1例输尿管穿孔。结论：气压弹道碎石联合ESWL治疗输尿管中下段结石有高效、安全、并发症少、适应证广的优点。     

Comparison of pneumatic and Holmium laser ureteroscopic lithotripsy for upper third ureteral stones

ObjectiveTo evaluate the outcomes of ureteroscopic lithotripsy with pneumatic lithotripter and Holium:Yttrium-Aluminum-Garnet (Ho:YAG) laser in the management of upper third ureteral stones.Materials and methodsPatients who underwent ureteroscopic lithotripsy with pneumatic lithotripter or Ho:YAG laser for upper third ureteral stones were retrospectively reviewed. Patients with urinary tract infection, radiolucent stones, loss of follow-up, concurrent middle or lower third ureteral stones or acute renal failure were excluded. Patient age, stone size and burden (based on KUB or computerized tomography), stone upward migration, double J stent insertion rate, stone free rate and secondary intervention rate for residual stones were compared in both groups.ResultsThere were 158 patients with 178 upper third ureteral stones (135 in pneumatic lithotripsy group and 43 in Ho:YAG laser lithotripsy group) meeting the study criteria. Patients' age, gender, stone laterality, stone size and burden were similar in both groups. The Ho:YAG laser lithotripsy group had better stone free rate, less double J stent insertion rate and less secondary intervention rate as compared with pneumatic lithotripsy (53.4% vs. 40.1%; 72.1% vs. 91.9%; 25% vs. 48.5% respectively, all p < 0.05). In patients with stones larger than 10 mm, Ho:YAG laser lithotripsy had significantly lower upward migration rate, lower double J stent insertion rate, higher stone free rate and less secondary intervention rate.ConclusionsHo:YAG laser lithotripsy is superior to pneumatic lithotripsy in the management of upper third ureteral stones in terms of double J stent insertion rate, stone free rate and secondary intervention rate for stones of all sizes. For stones larger than 10 mm, laser lithotripsy results in less stone upward migration.     

输尿管镜下气压弹道碎石术(附160例报告)

目的 分析输尿管镜下气压弹道碎石术治疗输尿管结石的方法及并发症的防治。方法 总结采用输尿管镜下气压弹道碎石术治疗输尿管结石160例的临床资料。结果 一次性碎石成功率93．0％（11／149）,7d内结石排净率95．0％（142/149)。并发症发生率3．8％（6／160）,其中输尿管穿孔4例,泌尿系感染2例。结论 输尿管镜下气压弹道碎石方法较安全、疗效确切。     

Extracorporeal shock-wave versus pneumatic ureteroscopic lithotripsy in treatment of lower ureteral calculi

Aim: To compare the efficacy and complications of extracorporeal shock-wave lithotripsy (SWL) and pneumatic ureteroscopic lithotripsy (URS) in the treatment of lower ureteral calculi. Methods: From August 1997 to June 1999, 210 patients with calculi in the distal third of the ureter were treated with SWL and the other 180 with URS. The stones were fragmented with either HB-ESWL-V lithotripter or JML-93 pneumatic lithotripter through Wolf 7.5～9.0 Fr ureteroscope. The outcome was assessed in terms of stone clearance rate, re-treatment rate and complication incidence. Results: The stone clearance rate was 78.1% with SWL and 93.3 % with URS (P<0.05). SWL had a re-treatment rate of 11.9 %, vs 2.2 % in the URS group (P<.05). URS caused ureteral perforation in 3.3% of patients, while it was 0 with SWL (P<0.05). The differences in the incidence of other complications such as infection and stricture between the two groups were insignificant. Conclusion: Though the selection of these two options depends on equip