超声定位体外冲击波碎石治疗输尿管结石599例疗效研究.docVIP

超声定位体外冲击波碎石治疗输尿管结石599例疗效研究[摘要] 目的:评价体外冲击波碎石(ESWL)治疗输尿管结石的效果。方法:对ESWL治疗的输尿管结石599例(输尿管上段结石160例,输尿管中段结石93例及输尿管下段结石346例)进行回顾性分析,ESWL后1周～1个月及每6～12个月行超声或X线腹部平片检查及临床随访。结果:输尿管上段结石排净率为95.6%,输尿管中段结石排净率为93.5%,输尿管下段结石排净率为100.0%。结论:此方法是一种治疗输尿管结石的理想方法,具有操作简便、安全、痛苦少、效果满意、合并症少等优点,是输尿管结石的首选治疗方法。 [关键词] 体外冲击波碎石;输尿管结石;超声引导 [中图分类号] R693+.4 [文献标识码]B[文章编号]1673-7210(2009)08(b)-163-02 Ultrasound-guided extracorporeal shock wave lithotripsy for 599 cases of ureteral calculi HAN Wei, LI Jianhua, ZHANG Huachao (Department of Ultrasonography,Rongcheng People’s Hospital of Shandong Province, Rongcheng 264300, China) [Abstract] Objective: To evaluate the effect of extracorporeal shock wave lithotripsy (ESWL) in treating ureteral calculi. Methods: The 599 cases (upper ureteric calculi 160 cases, mid ureteric calculi 93 cases, lower ureteric calculi 346 cases) of ureteral calculi patients who applied ESWL were retrospectively analyzed, after ESWL 1 week to 1 month and in every 6-12 months we took ultrasonic examination and X-ray film inspection and clinical follow-up visit. Results: The clearance rate of upper ureteric calculi was 95.6%, the clearance rate of mid ureteric calculi was 93.5%, the clearance rate of lower ureteric calculi was 100.0%. Conclusion: This method is an ideal treatment for ureteral calculi, it has many advantages such as convenient manipulation, safe, few distress, satisfying effect, few complication etc, and it is the first choice for ureteral calculi. [Key words] Extracorporeal shock wave lithotripsy; Ureteral calculi; Ultrasound-guided 体外冲击波碎石(ESWL)是利用冲击波聚焦后瞬间能量转换将结石击碎,从而使结石颗粒随尿液排出体外[1]。目前这项技术已成为治疗上尿路结石的重要手段。笔者对2000～2008年在我院行ESWL治疗的1 065例尿路结石中的输尿管结石599例进行了回顾性分析,现将其疗效报道如下: 1 资料与方法 1.1一般资料 本组599例中,男457例,女142例;年龄12～79岁,平均46.8岁;左侧298例,右侧301例;结石位于输尿管上段160例,输尿管中段93例,输尿管下段346例,其中,右输尿管结石302例,左输尿管结石297例;结石直径4～22 mm,平均8.3 mm。输尿管上段结石直径5～21 mm,其中,20 mm 3例。临床表现:突发患侧腰腹部疼痛,恶心、呕吐及尿频、尿急、尿痛、血尿等,上段结石疼痛位于腰部、上腹部;中段结石疼痛放射至下腹部及会阴部;下段结石膀胱刺激征明显。所有病例多有不同程度的肾盂积水,结石梗阻