输尿管镜下气压弹道碎石术治疗60例输尿管上段结石

目的探讨输尿管镜下气压弹道碎石术治疗输尿管上段结石的临床疗效。方法置入输尿管镜，经膀胱逆行置入F5输尿管导管，缓慢将输尿管镜进入输尿管后在直视下观察结石，置入气压弹道碎石机进行碎石，取石结束后常规留置F6双J管。结果手术时间30～58min，（45．8±10．1）min；术中出血量7—18ml，（10．9±3．1）ml。8例由于术中结石冲人肾盂，术后改用体外冲击波碎石治疗，一次手术成功率86．7％（52／60）。2例分别于术后7、9d发生脓毒血症，经保守治疗痊愈。43例随访1—6个月，平均3个月，无肾积水及输尿管狭窄发生，术后1个月内结石均排净。结论输尿管镜下气压弹道碎石术治疗输尿管上段较小的结石疗效满意。

Ureteroscopic Pneumatic Lithotripsy for Upper Ureteral Calculi： a Report of 60 Cases

Objective To investigate the clinical effect of ureteroscopic pneumatic lithotripsy for upper ureteral calculi. Methods F5 ureteral catheter was placed through the bladder following the placement of ureteroscope. Catheter was slowly inserted into ureter and the calculi were observed directly. Air pressure ballistic lithotripter was entered to crush the stones and F6 double J tube was indwelled after removal of stones. Results The operative time was 30 - 58 min, with an average of （45.8 ± 10.1 ） min; the blood loss was 7 - 18 ml, with an average of（ 10. 9 ± 3. 1 ） ml. Calculi entered the pelvis in 8 cases, which were converted to extracorporeal shock wave lithotripsy after operation. The success rate of operation was 86.7% （52/60）. Two patients underwent sepsis 7 d and 9 d after operation respectively and recovered after conservative treatment. A total of 43 cases were followed up for 1 - 6 months with an average of 3 months. No hydronephrosis or ureteral stenosis occurred. Stones were drained within 1 month after operation. Conclusion Ureteroscopic pneumatic lithotripsy is safe and feasible for upper ureter small stones.