气压弹道碎石术治疗输尿管结石的效果

①目的　观察新型气压弹道碎石机经输尿管肾镜治疗输尿管结石的临床效果。②方法　应用输尿管肾镜气压弹道碎石术治疗输尿管结石２０ 例（２１ 侧），包括输尿管上段结石６例，中段１ 例，输尿管下段结石１３ 例。③结果　１６ 例（１７ 侧）输尿管结石１ 次碎石成功，３０ｄ 碎石排净率为９４．０％ ．手术失败４ 例４ 侧， ２ 例结石碎片上移到肾盂或肾盏，改行体外冲击波碎石术；另２ 例因输尿管石街形成或输尿管迂曲，输尿管肾镜难以到达结石部位，改行开放手术。④结论　气压弹道碎石术是一种安全、高效的输尿管腔内碎石术，可作为输尿管中段和下段结石的首选治疗方法。

MANAGEMENT OF THE URETERIC STONES BY URETERORENOSCOPY AND BALLISTIC LITHOTRIPSY

Objective\ To observe effect of a new ballistic lithotriptor in the endoscopic management of ureteric calculi. Methods\ A total of 20 patients (21 stones) with ureteric calculi, including 6 upper third ureteric stones, 1 middle and 14 lower ureteric stone, were treated with the ballistic lithotriptor.\ Results\ Satisfactory fragmentation was obtained in 17 of the 21 stones (80.9%) with one treatment. The stone free rate at one month was 94.0%. 4 failures of fragmentation (19.1%) were encountered. In two cases stone fragments were pushed up into pelvis or calyces. Adjunctive extracorporeal shock wave lithotripsy were performed with success. In another two cases the ureterorenoscope couldn't reach the stones due to torturous ureter and steinstrasse formation. They underwent open surgeries for their stones.\ Conclusion\ The ballistic lithoclast is a safe and effective means of endoscopic lithotripsy, which is the treatment of choice for mid and lower ureteric stones.