输尿管镜气压弹道碎石术治疗输尿管结石

目的：探讨输尿管镜气压弹道碎石术治疗输尿管结石的疗效。方法：采用输尿管镜气压弹道碎石术治疗输尿管结石患者128例，其中5例为ESWL后输尿管石街形成，6例并发急性梗阻性肾功能不全。结果：128例中，一次性碎石成功117例，占91．4％。碎石失败11例，占8．6％，其中6例输尿管上段结石移位至肾盂，留置双J管后行ESWL治愈，另外2例输尿管穿孔和3例进镜失败患者均立即改行开放手术治愈。6例并发急性梗阻性肾功能不全患者碎石术后即进入多尿期，2周后复查肾功能恢复正常。结论：输尿管镜气压弹道碎石术治疗输尿管结石具有微创、安全、效果好等优点，可作为输尿管中、下段结石的首选治疗方法。

Transureteroscopic pneumatic lithotripsy in the treatment of ureteral calculi

Objective:To evaluate transureteroscopic pneumatic lithotripsy in the treatment of ureteral calculi.Methods:128 cases of ureteral calculi were treated with ureteroscopic pneumatic lithotripsy. There were 5 cases of ureteral steinstasse after ESWL and 6 cases of acute obstructive renal failure.Results:128 cases of ureteral stones were treated by ureteroscopic lithotripsy, of which 91.4 %(117/128) were fragmented on the first treatment session and 8.6 %(11/128) were unsuccessful. The proximal ureteral calculi were moved to renal pelvic and cured by ESWL after the double-J ureteral stent was placed in 6 cases. Open surgery was the choice after the ureteral perforation in 2 cases and the failure of inserting the ureteroscope in 3 cases. In 6 cases with acute obstructive renal failure, the polyuric stage followed ureteroscopic lithotripsy and the renal function was recovered after 2 weeks.Conclusions:Treatment of ureteral calculi by transureteroscopic pneumatic lithotripsy has been less invasive, safe and effective, and should be the first choice to the patients with middle and low ureteral stones.