ESWL治疗上尿路结石临床体会(附1847例报告)

目的 总结ESWL治疗上尿路结石的经验. 方法 2006年1月～2011年10月,采用国产HB-ESWL-VG型低能量碎石机治疗上尿路结石1 847例并随访. 结果 第一次治疗成功碎石排石1 445例,有效率为78.2％,第二次治疗成功碎石排石370例,有效率为20.0％,治疗三次以上或转为手术等其他治疗方法的32例(1.7％).术后两周复查1 847例,随访率100％.6周内结石排净率为98％(1 810/1 847).并发症:患者术后均出现肉眼血尿,均轻微,肾结石患者术后12 ～ 24h内消失,输尿管结石患者术后血尿12h内消失；输尿管绞痛25例(1.4％),经静脉补液、解痉、止痛后缓解；输尿管石街形成12例(0.6％),经再次ESWL石街消失. 结论 ESWL治疗上尿路结石疗效确切,损伤较小,是一种安全、有效的治疗方法,值得推广.

Clinical Experiences of ESWL in Treatment of Upper Urinary Calculi(A Report of 1 847 Cases)

Objective To study the experience of extracorporeal shock wave lithotripsy(ESWL) in treatment of upper urinary calculi.Method Between January 2006 and October 2011,1 847 patients received low-energy ESWL for the upper urinary calculi by domestic lithotripter of model HB-ESWL-VG and were followed up.Results The first treatment success was achieved in 1 445 cases(78.2%).The second treatment success was achieved in 370 cases(20.0%).More than 3 times of ESWL or conversion of other operation was needed in 32 cases(1.7%).All patients were followed up after every procedure,and the six-week-stone-free rate was 98%(1 810/1847).All patients got mild gross hematuria which disappeared within 12 ~ 24h in kidney stones and within 12 h in ureteral calculi.Ureteric colic was occurred in 25 cases(1.4%).And ureteral stone street was formed in 12 cases(0.6%).Conclusion ESWL is safe and effective for the treatment of upper urinary calculi and potentially leads to less injury.It is worthy to be recommended.