ESWL补救治疗输尿管镜气压弹道碎石失败的输尿管结石28例临床观察

目的探讨输尿管镜下气压弹道碎石术治疗输尿管结石失败后体外冲击波碎石（ESWL）补救的治疗效果。方法回顾性分析2007年5月至2008年12月输尿管结石患者28例，均为输尿管镜下气压弹道碎石术失败，采用ESWL补救治疗，观察碎石的效果。结果28例经体外冲击波碎石治疗，碎石效果良好，碎石逐步随尿液排出体外，1～2周后在膀胱镜下拔除双J管，复查尿路平片示无残余结石。结论输尿管镜下气压弹道碎石对于输尿管下段结石效果较好，上段结石容易因结石上漂造成气压弹道碎石失败，体外冲击波碎石提供了补救治疗的方法，碎石效果好。

Extracorporeal shock-wave lithotripsy therapy in treatment of ureteral calculi failed with transureteroscopic pneumatic lithotripsic treatment

Objective To evaluate extraeorporeal shock - wave lithotripsy （ESWL） in treatment of ureteraf calculi failed with transureteroscopic pneumatic lithotripsy. Methods Clinical data of 28 cases of ureteral calculi failed with transureteroseopie pneumatic lithotripsy treated with ESWL were retrospectively analyzed. The effect of ESWL was closely observed. Results Twenty eight cases were successfully treated with ESWL and all of them showed stone free from urine. The J tubes were pull out under cistoscopy after 1-2 weeks. There was no retained calculus rechecked in KUB. Conclusion The treatment of inferior segment ureteral calculi with transureteroseopic pneumatic lithotripsy is effective, but its treatment for superior segment ureteral calculi is easy to be failed due to upward displacement of the stone. ESWL should be applied as the first choice for superior segment ureteral stone after failed treatment with transureteroscopic pneumatic lithotripsy.