输尿管肾镜下气压弹道碎石术治疗输尿管结石

目的 探讨输尿管肾镜下气压弹道碎石的临床疗效。方法 应用输尿管肾镜气压弹道碎石术治疗输尿管结石102侧，包括上段结石18例，中段结石26例，下段结石58例。结果 92例输尿管结石1次碎石成功，1月碎石排尽率77．17％；6例输尿管结石上移至肾盂或肾盏，改行ESWL治疗；2例输尿管穿孔，2例因输尿管迂曲，输尿管肾镜难以达到结石部位改行开放手术治疗。结论 气压弹道碎石术是一种安全、效果确切、损伤小的治疗方法，如与ESWL方法结合应用疗效更佳。

Management of ureterial calculi with ureterorenoscopy-guided ballistic lithotripsy

Objective To evaluate the effect of ureterorenoscopic ballistic lithotripter (URSL) on the treatment of ureterial calculi. Methods A total of 98 patients with 102 stones in the ureter, including 18 upper, 26 middle and 58 lower ureterial stones, were treated with the ballistic lithotripsy under the guide of ureterorenoscopy. Results Satisfactory fragment was obtained in 92 of the 102 stones with only URSL treatment for one time. The stone free rate at 1 month was 77.17%. Stone fragments were pushed up into the pelvis or calyces in 6 cases, in these cases adjunctive extracorporeal shock wave lithotripsy (ESWL) were performed. Ureteral perforation occurred in 2 cases. And another 2 cases were not managed with URSL due to torturous ureter. In these 4 cases open surgery was needed for their stones. Conclusion Ballistic lithotripsy is a safe, effective and mild invasive method in the treatment of ureteral calculi, and better outcomes will be attained when being combined with ESWL.