输尿管镜下气压弹道治疗输尿管结石453例报道

目的总结输尿管镜下气压弹道碎石治疗输尿管结石的临床效果和经验。方法回顾性分析453例输尿管结石行输尿管镜下气压弹道碎石的临床资料。结果453例患者行输尿管镜下气压弹道碎石术，成功420例，成功率为92．7％（输尿管上、中、下段结石的成功率分别为76．0％、93．0％、96．0％），术后手术并发症发生率为8．4％。结论在液压灌注泵冲扩下多可用“上挑内旋”法将输尿管镜成功置入输尿管。输尿管镜下气压弹道是中、下段输尿管结石的首选治疗方法。对输尿管镜碎石失败者，尽量留置双J管后行ESWL治疗，大多数可获得成功。

Report of Pneumatic Lithortripsy under Ureteroscope for 453 Cases of Ureteral Calculi

Objective To summarize and compare the clinical effects and experience of pneumatic lithotripsy under ureteroscope for ureterai calculi. Methods Retrospectively the data of 453 cases of ureteral calculi were analysed. Results The whole success rate is 92.7%（The success rates for upper, middle and lower ureteral calculi were 76.0% ,93.0% and 96.0% respectively） and the complication rate is 8.4%. Conclusion Ureteroscope could be put into most ureter with the method of ＂stiting up-turning medially＂ under automated irrigation/suction pump system. Pneumatic lithotripsy under ureteroscope is an effective method and should be the first choice of treatment for middle and lower ureteral stones. For most failed patients, extracorporeal shock wave lithotripsy（ESWL） should be undergone after inserting D-J catheter and maybe succeed at last.