表麻下输尿管镜取石术治疗输尿管结石并肾绞痛

目的探讨在表麻下输尿管镜取石术治疗输尿管结石并肾绞痛的安全性、有效性和病人的耐受性。方法 54例输尿管下段、12例输尿管中段和5例输尿管上段结石的门诊病人在表麻下行输尿管镜取石术。4例行输尿管口气囊扩张术。结果 65例患者术中取出结石,2例患者结石碎片3天内排出,结石排净率94.3%,迅速缓解肾绞痛,无输尿管穿孔的发生,也无与表麻相关的并发症。在输尿管镜取石术过程中,80%(24/30)男性和95.1%(39/41)女性能耐受手术的痛苦(包括5例输尿管上段结石),11.2%不能耐受手术的痛苦。结论表麻下输尿管镜取石术治疗输尿管结石并肾绞痛是安全有效的且病人耐受性好,可替代冲击波碎石术。

Ureteroscopy with Topical Anesthesia for Treatment of Ureteral Calculi with Renal Colic

Objective We evaluated the safety,efficacy and patient tolerance of ureterescopy with topical anesthesia for treatment of ureter- al calculi with renal colic.Methods Ureteroscopy with topical anesthesia was performed in 54 patients with distal ureteral calculi,in 12 with mid- dle third ureteral calculi and in 5 with upper third ureteral calculi.Balloon dilation of the ureter was performed in 4 patients.Results Stone re- moval was successful in 67 patients (94.3%).Renal colic was relieved rapidly.There were no ureteral perforations in patients undergoing suc- cessful stone removal and no complications related to topical anesthesia.Tolerance of the procedure was good in 88.7% of the patients (including 80% of 30 men and 95.1% of 41 women undergoing ureteroscopy for ureteral calculi) and fair in 11.2%.Conclusions In select patients with ureteral calculi ureteroscopy offers a safe,effective and well tolerated alternative to shock wave lithotripsy.