原发性巨输尿管症合并结石行体外碎石疗效

doi:10.3877/cma.j.issn.1674-3253.2020.03.017

中华腔镜泌尿外科杂志(电子版) ›› 2020, Vol. 14 ›› Issue (03) : 228 -231. doi: 10.3877/cma.j.issn.1674-3253.2020.03.017

所属专题：经典病例；文献；

病例研究

原发性巨输尿管症合并结石行体外碎石疗效

苑海春¹^,^†(

), 薛玉泉², 焦杨¹, 侯会滨¹, 王振¹

^1. 710054　西安，武警陕西省总队医院碎石科
^2. 710004　西安，西安交通大学第二附属医院泌尿外科

收稿日期:2019-03-20 出版日期:2020-06-01
通信作者: 苑海春

Experiences of extracorporeal shock wave lithotripsy for calculus in primary megaureter

Haichun Yuan¹^,^†(), Yuquan Xue², Yang Jiao¹, Huibin Hou¹, Zhen Wang¹

^1. Department of Lithotripsy, Shanxi Province Corps Hospital, Chinese People’s Armed Police Force, Xi'an 710065, China
^2. Department of Urology, the Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710004, China

Received:2019-03-20 Published:2020-06-01
Corresponding author: Haichun Yuan
About author:
Corresponding author: Yuan Haichun, Email: 570295160@qq.com

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目的

探讨原发性巨输尿管合并结石行体外冲击波碎石治疗的可行性，为临床治疗提供参考。

方法

2013年1月至2018年6月武警陕西省总队医院试探性对原发性巨输尿管合并结石患者行体外冲击波碎石治疗，观察疗效，总结经验。12例患者中有14侧巨输尿管，其中右侧4例，左侧6例，双侧2例；输尿管全程扩张5例，中下段扩张7例；巨输尿管内经1.5～2.5 cm，平均（1.9±0.4）cm；治疗的结石中输尿管结石11例，肾结石1例；结石长径0.6～1.9 cm，平均（1.2±0.4）cm。

结果

1例碎石1次后放弃体外碎石治疗选择了输尿管镜碎石取石术，11例最终将结石成功排出，碎石1次～5次，平均（2.4±1.6）次，成功率91.67%，其中碎石1次成功率33.33%。并发症发生率25%，包括肉眼血尿、排石过程中疼痛、呕吐，无严重并发症。

结论

原发性巨输尿管合并的结石可采用体外冲击波碎石治疗，但1次碎石成功率较低。

关键词: 巨输尿管, 输尿管结石, 肾结石, 体外碎石, 体位

Objective

To investigate the feasibility of extracorporeal shock wave lithotripsy (ESWL) for calculus in primary megaureter, and to provide references for clinical treatment.

Methods

The calculus in primary megaureter was treated by ESWL from January 2013 to June 2018 in our hospital. The curative effect was observed and the experiences were summarized. There were 14 megaureteral units in 12 patients. There were 4 cases with right megaureter, 6 cases with left megaureter and 2 cases with both sides. 5 cases was dilatatied completely and 7 cases was dilatated at middle and lower ureter. The inner diameter of the megaureter was 1.5-2.5 cm, with the mean of (1.9±0.4) cm. There were 11 cases with ureteral calculus and 1 case with renal calculus. The length of calculus was 0.6-1.9 cm with the mean of (1.2±0.4) cm.

Results

1 case gave up ESWL after one time lithotripsy and chose ureteroscopic lithotripsy. 11 cases excreted the stones successfully after 1 to 5-time lithotripsy, with the mean of (2.4±1.6) times. The clearance rate was 91.67%, and the one-time success rate was 33.33%. The incidence of complications was 25%, including gross hematuria, pain and vomiting, without serious complications.

Conclusion

Calculus in primary megaureter could be treated by ESWL, but the one-time success rate is low.

Key words: Primary megaureter, Ureteral calculus, Kidney stones, ESWL, Surgical position

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