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体外震波碎石技术的问世及腔内器械的改良,使尿路结石的治疗发生了根本的改变。输尿管结石的部位不同,各种疗法的成功率亦不同,因此,如何合理地、有先有后地应用这些技术十分重要。 2年前作者曾总结158例输尿管结石的治疗经验,认识到(1)充填嵌顿性输尿管结石以ESWL治疗是困难的,必须作器械取石,若作ESWL治疗应先插入输尿管支架管;(2)输尿管上段结石作输尿管镜取石较为困难;(3)ESWL对阴性结石或钙化不良的结石定位困难,对不能经输尿管排出或取出碎石的结石亦有困难。为此,作者曾推荐如下的治疗程式:(1)输尿管交界处和上段结石(L_1～L_3)作经皮肾手术。或插支架管后作ESWL;(2)中段结石(L_3～S_1)若可置入支
The advent of extracorporeal shock wave lithotripsy and the improvement of intracavitary instruments have fundamentally changed the treatment of urinary tract stones. The site of ureteral stones is different, the success rate of various treatments are also different, therefore, how to apply these technologies first and foremost is very important. Two years ago, the author summed up 158 cases of ureteral calculi treatment experience and realized that (1) the treatment of incarcerated ureteral stones with ESWL treatment is difficult and must be taken for lithotomy equipment, if ESWL treatment should be inserted ureteral stent tube; (2 ) Upper ureteral stones ureteroscopic stone is more difficult; (3) ESWL of negative stones or poor calcification of the stones difficult to locate on the ureter can not be discharged or remove stones and stones are also difficult. To this end, the authors have recommended the following treatment: (1) ureter junction and the upper stones (L_1 ~ L_3) for percutaneous nephrectomy. Or inserted stent tube for ESWL; (2) the middle stone (L_3 ~ S_1) if it can be placed in the branch