电子动能碎石术治疗上尿路结石

目的　总结电子动能碎石术治疗上尿路结石的疗效。方法　回顾性分析 166例电子动能碎石术治疗的上尿路结石患者资料。男 96例 ,女 70例 ,年龄 16～ 62岁 ,平均 3 9岁。肾结石 2 7例 ,输尿管上段结石 42例 ,中段 3 5例 ,下段 62例。采用mPCNL治疗 42例 ,URSL12 4例。结果　mPCNL碎石成功率 10 0 % ,15例输尿管上段结石行mPCNL ,结石清除率 10 0 %。URSL碎石成功率 83 .0 6% ( 10 3 /12 4)。URSL时结石移位至肾盂或肾下盏 9例 ,发生输尿管穿孔 6例。随访 10 3例 ,随访时间 1～ 16个月 ,术后 1月结石排净 96例。B超显示肾积水较术前明显减少或消失。结论　电子动能碎石术治疗上尿路结石创伤小、成功率高、并发症少。微创经皮肾碎石取石是治疗合并中、重度肾积水的输尿管上段结石的首选方法。

Electrokinetic lithotripsy in the treatment of upper urinary tract calculi

Objective To evaluate minimally invasive percutaneous and ureteroscopic electrokinetic lithotripsy in treating of upper urinary tract calculi.Methods 166 cases of upper urinary tract calculi treated with electrokinetic lithotripsy from Jane.2001 to Nov.2003 were studied retrospectively.Among them,27 cases of renal stone and 15 cases of proximal stone were treated with minimally invasive percutaneous nephrolithotomy(mPCNL),124 cases of ureteral stone were treated with ureteroscopic lithotripsy(URSL).There were 96 male and 70 female with an age of 16 to 62,27 being renal,42 proximal ureteral,35 middle and 62 lower stone.Results The stone fragmentation rate treated with mPCNL/URSLwas 100%/83.06%.All the 15 cases of proximal stone treated with mPCNL were rendered stone free at 1 session.9 ureteral stone treated with URSL,stone and fragments were pushed up into the calyces.Ureteral perforation was in 6.103 cases were followed up for 1 to 16 months and 96 cases were stone free within 1 month.Conclusions The electrokinetic lithotripsy is an effective,safe and less invasive means of intracorporeal lithotripsy.Minimally invasive percutaneous nephrolithotomy is the first treatment for the proximal ureteral stone with hydronephrosis.