输尿管镜气压弹道碎石术治疗88例输尿管结石

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。方法回顾性分析2004年6月-2010年11月88例输尿管镜气压弹道碎石术治疗输尿管结石的临床资料。其中孤立肾7例,双侧结石9例,急性梗阻性肾功能衰竭14例。结果输尿管结石位于上、中、下段分别为20侧、28侧、50侧。一次性碎石91.8%,其中上段75.0%,中段92.8%,下段98.0%。3例改开放手术,体外震波碎石术（ESWL）5例。手术时间20100 m in,平均56 m in。急性肾功能衰竭患者血BUN,Cr恢复正常或接近正常。结论输尿管镜气压弹道碎石术安全、高效、损伤小,可作为输尿管中下段结石的首选方法,能同时处理双侧结石。对梗阻性急性肾功能衰竭,可快速解除梗阻

Treatment of 88 Cases with Ureteral Calculi by Using Ureteroscopic Pneumatic Ballistic Lithotripsy

Objective To evaluate the efficacy of ureteroscopic pneumatic ballistic lithotripsy for ureteral calculi.Methods A retrospective analysis was made in 88 cases treated by ureteroscopic pneumatic ballistic lithotripsy from June 2006 to November 2010.There are 9 cases of bilateral ureteral calculi,7 cases of isolated renal and 14 cases of acute obstructive renal failure.Results The locations of ureteral calculi were in the upper portion in 20 sides,in the middle portion in 28 sides,in the lower portion in 50 sides.The total success rate of one stage for patients was 91.8%（75.0% in upper portion,92.8% in middle portion,98.0% in lower portion）.The mean operation time was 56 minutes（range from 20 to 100 minutes）.3 cases were changed into open operation.5 cases needed auxiliary ESWL.In the patients with acute obstructive renal failure,the serum Bun and Cr levels decreased at different degree or return to normal.Conclusion The ureteroscopic pneumatic ballistic lithotripsy is safe,effective and less invasive,and is the first choice in the treatment of lower and middle ureteral calculi,which can treat the bilateral ureteral calculi simultaneously;it can rapidly remove the obstruction for the patients with obstructive acute renal failure