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目的:探讨对部分上尿路结石采用ESWL与输尿管镜碎石联合处理的方法。方法:对70例上尿路结石患者采用ESWL与输尿管镜下钬激光碎石(URS)联合交替治疗。其中输尿管结石48例,肾结石22例。结果:结石总排净率为91.4%(64/70),其中输尿管结石排净率为95.8%(46/48),肾结石排净率为81.8%(18/22)。3例治疗失败,其中1例输尿管结石因输尿管狭窄无法入镜;另2例肾结石,1例因交替治疗次数过多中途停止治疗,1例因结石硬度过大ESWL不佳,均改为PCNL术。结论:ESWL与URS联合交替进行的疗法处理上尿路结石,避免了创伤性治疗,扩大了ESWL治疗范围,降低了URS手术难度,缩短了URS操作时间,提高了结石排净率,患者创伤微小、恢复快、并发症少,是治疗上尿路结石,特别是部分复杂性上尿路结石较理想的方法之一。
Objective: To explore the method of combining ESWL with ureteroscopic lithotripsy for some upper urinary tract stones. Methods: Seventy patients with upper urinary tract stones were treated with ESWL combined with ureteroscopic holmium laser lithotripsy (URS). 48 cases of ureteral stones, kidney stones in 22 cases. Results: The total discharge rate of stones was 91.4% (64/70). The removal rate of ureteral stones was 95.8% (46/48) and the removal rate of kidney stones was 81.8% (18/22). 3 cases failed treatment, of which 1 case of ureteral calculi due to ureteral stricture can not be enrolled; the other 2 cases of kidney stones, 1 case of treatment due to excessive number of halting treatment, 1 case of stone ESWL due to poor hardness, were changed to PCNL Surgery. Conclusion: The combination therapy of ESWL and URS can effectively treat the upper urinary tract stones, avoid the traumatic treatment, enlarge the scope of ESWL treatment, reduce the difficulty of URS operation, shorten the operation time of URS, increase the rate of stone removal, , Rapid recovery, fewer complications, is the treatment of upper urinary tract stones, especially one of the more complex upper urinary tract stones one of the ways.