摘要
目的探讨急诊输尿管镜技术治疗输尿管结石梗阻并顽固性肾绞痛的疗效与临床意义。方法对710例输尿管结石梗阻伴顽固性肾绞痛患者在腰硬联合麻醉下行急诊输尿管镜(取石钳取石术、气压弹道碎石术、输尿管支架管置入术)治疗。结果全部710例患者术后肾绞痛症状完全消失;679例一次性碎石取石成功,结石完全取出,其中7例为双侧输尿管结石梗阻,同期处理对侧结石梗阻;17例上段结石碎石过程中移入肾脏者,给予输尿管支架管置入术,留置双J管内引流,于1周后带双J管行ESWL1～2次,门诊随访1个月,结石排出;14例因输尿管狭窄或扭曲输尿管镜无法到达结石部位而行输尿管支架管置入术,留置双J管内引流,于1周后带管行ESWL1～2次,门诊随访1个月,结石排出。1个月后复查结石全部排出。除1例中段结石输尿管轻微穿孔留置支架管1个月后恢复正常外其他患者无严重并发症发生。结论急诊输尿管镜技术是一种治疗输尿管结石梗阻伴急性顽固性肾绞痛的迅速、全面、微创、安全、有效并可同期处理对侧无症状输尿管结石伴梗阻的理想方法。
Objective To investigate emergency ureteroscopic techniques in the treatment of ureteral calculi obstruction and renal colic curative effect and the clinical significance.Methods 710 cases of ureteral calculous obstruction with refractory renal colic patients during combined spinal-epidural anesthesia（emergency ureteroscope lithotomy forceps lithotomy,pneumatic lithotripsy,ureteral stent implantation treatment）.Results All the710cases of patients with postoperative renal colic symptoms completely disappeared;679cases of disposable stones,stones removed entirely,among them 7 cases were bilateral ureteral calculous obstruction,earlier treatment on the side stone obstruction;17 cases calculi lithotripsy process into the kidney,ureter stent implantation to give,indwelling double J tube within1 weeks after drainage,with double J tube rows ESWL 1～2,outpatient follow-up of 1 months,discharge the stone;14 cases with ureteral stricture or distortion of ureteroscopy can not reach the location of stones and ureteral stent implantation,indwelling double J tube drainage,in1 weeks after the band tube rows ESWL 1～2,outpatient follow-up of 1 months,discharge the stone.After 1 months all stones discharge.Except for 1 cases of middle stone ureter perforation tube slightly indwelling stent1 months after return to normal and other patients without severe complications.Conclusion Emergency ureteroscopic technique is a kind of treatment of ureteral calculous obstruction associated with acute renal colic rapid,comprehensive,minimally invasive,safe,effective and capable of simultaneous treatment of the contralateral asymptomatic ureteral calculi complicated with obstruction of the ideal method.
出处
《当代医学》
2012年第20期117-119,共3页
Contemporary Medicine
