合用阿托品输尿管逆行造影联合IVU定位行ESWL治疗输尿管阴性结石疗效观察(附138例报告)

目的:探讨合用阿托品输尿管逆行造影联合IVU定位行ESWL治疗输尿管阴性结石的临床效果。方法:术前138例患者经B超、IVU、CT检查确诊输尿管阴性结石。采用IVU联合应用阿托品针、碘海醇针合剂经输尿管导管持续微泵泵入,行逆行造影(RGU)辅助,经X线定位后,明确结石的部位及大小后行ESWL治疗。留置输尿管导管综合排石治疗3～5天,观察临床碎石效果。结果:本组138例患者经1次ESWL治疗后2～4周,121例(87.8%)结石完全排净,第2次ESWL治疗结石排净10例(7.2%),第3次ESWL治疗结石排净2例(1.4%);2例(1.4%)形成石街,需行输尿管镜取石;无效3例(2.2%),行开放手术取石,证实结石有炎性肉芽包裹。结论:合用阿托品输尿管逆行造影联合IVU定位行ESWL治疗输尿管阴性结石临床疗效确切,术后留置输尿管导管逆行灌注冲洗利于排石。

Clinical observation for EWSL treatment on urinary negative calculi by atropine retrograde urography combined with intravenous pyelography location

Objective:To observe the clinical effects of extracorporeal shock wave lithotripsy(EWSL) by atropine retrograde urography combined with intravenous pyelography(IVU) location in treatment of urinary negative calculi.Methods:138 cases were diagnosed ureteral stones by B-ultrasound,IVU and CT.All the cases combined IVU with atropine needles,continuous pumped iohexol needle mixture through the ureteral catheter micro-pump,retrograde urography(RGU) to assist clearly the stones X-ray location and size before ESWL treatment.Then the cases retained the ureteral catheter and consolidated treatment of the row of stone 3-5 days to observe the clinical effects.Results:Among the 138 cases,121 patients(87.8%) completely drained after a second 2-4 weeks after the first ESWL treatment;10 patients(7.2%) completely drained by the second ESWL treatment;2 patients(1.4%) completely drained by the third ESWL treatment;2 cases(1.4%) formed a stone street and needed to line transurethral ureteroscopic lithotripsy(URL);3 cases(2.2%) were ineffective and needed the opened stone surgery,which cases were confirmed stones wrapped by the inflammatory granulation package.Conclusions:EWSL treatment on urinary negative calculi by atropine retrograde urography combine with intravenous pyelography location is curative effect.Retrograde perfusion washing help stone drain after ESWL.