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目的总结输尿管镜下气压弹道碎石术治疗上尿路结石的临床经验。方法回顾分析1995年4月-2005年5月输尿管镜配合气压弹道碎石机对3000例上尿路结石进行腔内碎石处理的临床资料。结果输尿管镜下一次碎石成功率:肾盂100%(44/44),输尿管上段83.2%(810/974),中下段97.0%(1922/1982)。2例发生输尿管穿孔,1例输尿管撕裂(金属导丝穿通1例当即留置双J管,输尿管镜戳孔1例观察2天后开放手术,输尿管镜断裂1例当即转开放手术)。810例碎石成功的上段输尿管结石及44例肾盂结石3个月内结石排净839例(98.2%);1922例碎石成功的中下段结石3个月内结石排净1919例(99.8%)。结论使用输尿管镜下气压弹道碎石治疗上尿路结石安全有效,创伤小,对中下段输尿管结石处理最为适宜。
Objective To summarize the clinical experience of ureteroscopic pneumatic lithotripsy in the treatment of upper urinary tract calculi. Methods The clinical data of endoscopic lithotripsy of the upper urinary calculi treated by ureteroscope combined with pneumatic ballistic lithotripsy from April 1995 to May 2005 were retrospectively analyzed. Results The success rate of ureteroscopic lithotripsy was 100% (44/44) in the renal pelvis, 83.2% (810/974) in the upper ureter and 97.0% (1922/1982) in the middle and lower ureter. 2 cases of ureter perforation occurred, 1 case of ureteral tear (metal guide wire puncture immediately indwelling double J tube, 1 case of ureteroscopic poke hole observed 2 days after open surgery, ureteroscopic rupture in 1 case immediately switch to open surgery). Of the 810 cases, 839 (98.2%) had stones in the upper ureteral calculi and 44 cases of pyelolitholithiasis discharged in 3 months, 1919 (99.8%) had stones in 3 of 1922 cases, . Conclusion The use of ureteroscopic pneumatic lithotripsy is safe and effective in treating upper urinary tract stones with minimal trauma and is most suitable for the treatment of ureteral stones in the middle and lower segments.