323例肾结石体外冲击波碎石术治疗体会.doc

323例肾结石体外冲击波碎石术治疗体会【摘要】目的 回顾性总结分析体外冲击波碎石术（ESWL）治疗肾结石的疗效和体会. 方法 对323例肾结石患者采用MZ.ESWL-V型机进行碎石治疗，X线定位，治疗时患者仰卧位，冲击能量6-8KV，冲击次数2500-3000次，二次碎石治疗间隔时间二周以上，术后给予抗感染、排石和利尿等处理，术后1-3周复查B超和腹部平片（KUB），3～6个月进行定期随访。结果 86例肾结石患者经1-4次碎石治疗后结石排空，碎石有效率为88.54%，术后患者有不同程度疼痛和血尿，并发症输尿管“石街”6例（1.85%），肾包膜血肿1例（0.3%）结论 ESWL治疗肾结石疗效可靠，只要正确使用碎石技术，掌握好适应症，就能提高治疗效果。 【关键词】肾结石 体外冲击波碎石术 中图分类号：R692.4 文献标识码：B 文章编号：1005-0515（2010）12-127-02 323 cases of kidney stones treatment of extracorporeal shock wave lithotripsy Zhang Yuling Xianning Central Hospital Zip: 437100 【Abstract】 Objective A retrospective analysis of extracorporeal shock wave lithotripsy (ESWL) treatment of kidney stones of the efficacy and experience. Methods 323 patients were treated with kidney stones MZ.ESWL-V type of lithotripsy machine, X ray localization, treatment in patients with supine position, the impact energy of 6-8KV, the impact of the number of 2500-3000 times a second stone treatment interval more than two weeks time, after giving antibiotics, and diuretics and other treatment Pai Shi, review 1-3 weeks after ultrasound and abdominal plain film B (KUB), 3 ~ 6 months for regular follow-up. Results 286 cases of kidney stone patients after treatment by 1-4 times emptying stone, gravel effective rate was 88.54%, with varying degrees of postoperative pain and hematuria, ureteral complications, “Stone Street” in 6 cases (1.85% ), renal capsule hematoma in 1 patient (0.3%) Conclusion ESWL treatment of kidney stones effective and reliable, as long as the proper use of lithotripsy, have good indications, will be able to improve the therapeutic effect. 【Key words】 kidney; extracorporeal shock wave lithotripsy; 体外冲击波碎石术由于疗效高，安全可靠，费用低，病人治疗时痛苦小，现已成为泌尿系结石治疗的常规方法。我科2004年8月～2009年6月收治肾结石患者323例，采用ESWL治疗收到较好疗效，现将治疗体会报告如下： 1 资料与方法 1.1 临床资料 本组肾结石患者323例，男226例，女97例，左肾结石145例，右肾结石153例，多发性结石23例，双肾结石25例，结石直径0.6～2.2cm,B超、静脉尿路照影（IVU）显示，患侧肾盂轻、中度积水，输尿管无狭窄。 1.2 方法 对323例患者采用MZ.ESWL-V型碎石机进行治疗，X线定位，治疗时患者仰卧位，冲击能量6-8KV，冲击次数2500-3