B超引导经皮肾盂穿刺造影配合ESWL治疗输尿管结石（附45例…

通过Ｂ超引导经皮肾盂穿刺造影配合ＥＳＷＬ，治疗用常规方法Ｘ线难以定位的输尿管结石４５例，一次性穿刺全部成功，碎石成功率９３．３％，本组未出现严重并发症。     

急诊ESWL治疗212例输尿管结石体会

为论证体外冲击波碎石术(ESWL)治疗输尿管结石致肾绞痛的临床效果,对212例输尿管结石致肾绞痛患者行ESWL治疗,效果满意。认为出现输尿管结石致肾绞痛时应及早施行ESWL,以求尽快解除患者痛苦;结石定位诊断应遵循简单、快捷的原则。     

侧卧位ESWL治疗输尿管上段结石

从１９９６年１０月～１９９８年１０月,我院采用深圳科达新技术有限公司生产的ＮＥ－ＶＢ型电磁冲击波水囊式体外碎石机侧卧位定位和治疗输尿管上段结石８６例,获得满意效果,现报告如下。１　资料与方法１．１　临床资料本组８６例,男５２例,女３４例,年龄１７～６１岁,平均３５岁。均为输尿管上段结石（髂骨嵴以上）。病程＜１周２９例,１周～１年３９例,＞１年１８例。左侧３９例,右侧４４例,双侧３例。结石大小为０．６ｃｍ×０．４ｃｍ～２．５ｃｍ×１．４ｃｍ。结石距髂嵴３ｃｍ以上者７６例（７９枚）,距髂嵴３ｃｍ以内…     

输尿管结石的B超诊断（附2568例报告）

为了提高输尿管结石的确诊率，１９８５年６月～１９９５年１２月应用Ｂ超诊断输尿管结石２５６８例。结果显示：结石位于上下两段占９３５％；无积水者占２１３％，且多为下段结石。认为肾绞痛发作是扫描最佳时机，下段扫描须降低仪器增益，膀胱以不影响探头加压的良好充盈为宜，寻找结石可以自上而下或自下而上。超声检出输尿管结石诊断可以确立，未检出结石不能否定其存在。     

急诊ESWL治疗输尿管结石疗效观察

为论证体外冲击波碎石术（ＥＳＷＬ）治疗输尿管结石绞痛的临床效果，对１０９例输尿管结石绞痛患者行急诊ＥＳＷＬ治疗，结果经１次ＥＳＷＬ治疗成功者９６例（８８．１％），余经第２次ＥＳＷＬ治疗全部碎石成功。经１次ＥＳＷＬ治疗后绞痛缓解者９５例（８７．１％）。认为出现输尿管结石绞痛时应及早施行ＥＳＷＬ，以求尽早解除患者痛苦；结石定位诊断应遵循简单、快捷的原则，综合分析，防止误诊；施行ＥＳＷＬ时应尽可能采用仰     

输尿管插管注水配合体外冲击波碎石治疗输尿管结石

目的　探讨输尿管内注水体外冲击波碎石术治疗难治性输尿管结石的临床疗效。　方法　对 5 98例难治性输尿管结石采取逆行输尿管插管 ,输尿管内高压 (10 0ml/ 5min)注入生理盐水 ,同时进行体外冲击波碎石。　结果　患者一周内排石率 10 0 %。一周内结石排净率 77% (4 60 / 5 98) ,两周内结石排净率 98% (5 85 / 5 98) ,两个月结石排净率 10 0 %。　结果　输尿管插管注水配合体外冲击波碎石是治疗难治性输尿管结石的良好方法。     

ESWL治疗输尿管石街的研究

目的：总结分析输尿管石街ESWL的技巧与方法,旨在提高其单纯ESWL的成功率。方法：将117例输尿管石街分为粉末型（26例）,蛇头型（72例）,石块型（19例）。不同类型的石街按不同治疗方法处理。结果：①粉末型石街长度≤5cm 21例,仅药物对症排石治疗2周排净13例,4周排净8例;长度〉5cm5例,ESWL一次2周排净3例,4周排净2例。②蛇头型石街72例,其中ESWL一次2周排净38例,4周排净22例,3个月排净5例,有7例2周复查时行第二次ESWL,2～4周复查均排净。③石块型石街19例,ESWL一次2周排净3例,4周排净4例,3个月排净5例;其中有7例2周复查时行第二次ESWL,4周复查排净3例,4例行第三次ESWL,2例2个月排净,1例3个月复查排净,1例历时半年排净。上述117病例中有9例出现患侧肾绞痛或（和）发热、明显肉眼血尿,予抗炎解痉等对症治疗或感染控制后即予ESWL,症状均缓解或消失,余病例均无严重并发症。结论：ESWL治疗输尿管石街具有清除率高、损伤少、安全性高、并发症少、可重复治疗等优点,对于碎石机性能较好、ESWL技术成熟的医疗单位,尤其对于无腔内微创治疗条件的医院,目前仍可作为首选的治疗方法。     

弹道碎石联合体外冲击波碎石治疗输尿管结石

目的探讨气压弹道碎石术联合体外冲击波碎石(extracorporeal shock wave lithotripsy,ESWL)治疗输尿管结石的临床价值. 方法采用气压弹道碎石术联合ESWL治疗输尿管结石365例. 结果 365例中,360例(98.6%)成功,2例失败(改开放手术),3例输尿管穿孔.80例配合ESWL.术后2周复查,结石均排净. 结论气压弹道碎石术联合ESWL治疗输尿管结石具有疗效高,损伤小,适应证广等优点.     

经尿道输尿管镜联合体外震波碎石治疗输尿管结石256报告

目的探讨输尿管镜联合体外震波碎石（extracorporeal shock wave lithotripsy，ESWL）治疗输尿管结石的价值。方法2005年10月-2007年6月采用输尿管镜联合ESWL治疗输尿管结石256例，中段（56例）及下段（170例）结石用输尿管镜取石，上段（30例）结石用ESWL碎石，输尿管镜取石失败或结石残留联合ESWL治疗。结果输尿管下段结石一期结石清除率98．2％（167／170），中段结石一期结石清除率89．2％（50／56），上段结石一期结石清除率73．3％（22／30）。输尿管穿孔3例，输尿管黏膜撕脱1例，结石远端输尿管扭曲进镜致使尿管穿孔改切开取石1例，输尿管镜取石失败或结石残留联合ESWL治疗二期结石清除率91．7％（11／12）。结论输尿管镜治疗输尿管下段及中段结石成功率高，输尿管镜取石失败或结石残留联合ESWL可提高二期结石清除率。     

输尿管结石气压弹道碎石术与体外冲击波碎石术疗效比较

目的：比较输尿管结石气压弹道碎石术与体外冲击波碎石术的疗效。方法：回顾分析130例气压弹碎石术与1600例体外冲击波碎石术的的碎石率、结石排净率、平均结石排净时间及并发症发生率。结果：气压弹道碎石术碎石率、结石排净率均大于体外冲击波碎石术，平均结石排出时间小于体外冲击波碎石术，并发症发生率两组问无明显差异。结论：输尿管结石行气压弹道碎石术优于体外冲击波碎石术。     

ESWL治疗上尿路结石480例临床分析

目的探讨上尿路结石体外冲击波(ESWL)的治疗效果。方法回顾性分析480例肾及输尿管结石患者行ESWL治疗的效果。结果 ESWL治疗1～3次结石粉碎并排净者473例,治愈率(98.5%)。7例(1.5%)ESWL治疗无效改行输尿管镜或外科手术治疗。结论体外冲击波碎石对于治疗肾及输尿管结石效果满意。     

Prospective randomized evaluation of emergency extracorporeal shock wave lithotripsy (ESWL) on the short-time outcome of symptomatic ureteral stones

OBJECTIVE: Here, we report the results of a randomized controlled trial (RCT) assessing the efficacy of emergency ESWL (eESWL) on the short-term outcome of symptomatic ureteral stones. MATERIAL: The trial enrolled 100 patients admitted in emergency room for renal colic caused by a ureteral radioopaque [corrected] stone. Patients were randomized to medical therapy alone or combined with eESWL. eESWL was performed within 6 hours of the onset of renal colic without specific analgesia on a Lithostar lithotripter (Siemens Medical, Munich, Germany). The primary endpoints were the proportion of patients stone free rate after 48 hours (SF-48) and the cumulative proportion of patients discharged from the hospital after 48 and 72 hours. RESULTS: Ureteral stone's location was proximal and distal in respectively 46% and 54% of the patients; stone's mean size was 5.5 mm (range 2-10 mm). Median hospital stay was 3 days, ranging from 1 to 14 days. SF-48 in the control group varied from 76% for distal stones <5 mm to 28.6% for proximal stones >5 mm, averaging at 61%. On average, eESWL increased SF-48 by 13% (p: 0.126), the gain strictly depending on stone size and location. SF-48 increase ranged from 40% for proximal stones >5 mm to 1.8% for distal stone <5 mm. On average, eESWL increased the median duration of hospital stay by one day. This mean negative impact results from ESWL increasing significantly the duration of hospital stay in case of distal stone, while slightly shortened it for stones located proximally. CONCLUSION: This study demonstrated for the first time that rapidly performed ESWL is a valuable therapeutic option to improve elimination of ureteral stones and shorten duration of hospital stay, proven that the stone is located proximally to the iliac vessels.     

磁共振成像尿路造影在输尿管结石诊断中的价值

目的 探讨磁共振成像尿路造影（ＭＲＵ）在输尿管结石诊断中的价值。方法 采用ＭＲＵ诊断输尿管结石４７例,其中ＩＶＵ患侧输尿管不显影者１５例,孤立肾尿管结石者３例,双侧结石合并上尿路扩张、积水者６例,结石合并肾功能不全者５例,因逆行插管失败者３例,另外高龄者５例、碘过敏者２例,不通耐受腹部加压、拒绝行ＩＶＵ或逆行尿路造影者５例。结果 ４７例输尿管结石患者中３４例可清晰显示结石上下方的尿路情况（７２％）     

ESWL by a second generation unit in patients with implanted cardiac pacemakers

Journal of Anesthesia -