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1、输尿管镜下气压弹道碎石术治疗输尿管结石岀现的常见并发症及其防治对策（附1629例报道）姜小琴1,2肖民辉2申杰2（通讯作者）（1大理大学临床医学院云南大理671000）（2云南省第一人民医院云南昆明650000）【摘要】目的：总结经尿道输尿管镜下气压弹道碎石取石术出现的常见并发症及其防治对策方法：对我院泌尿外科2003年5月・2014年10月应用输尿镜下气压弹道碎石取石术治疗输尿管结石出现并发症的病例（198例）进行分析。男性1208例，女性421例；平均年龄40.5岁。结石有726例位于输尿管下段,668
2、例位于输冰管屮段，235例位于输尿管上段。结果：本组1629例输尿管镜下气压弹道碎石取石术，一次性碎石成功率91.8%（1496/1629）,现并发症198例，其屮结石移位至肾盂69例及结石残留需彳亍ESWL等辅助治疗75例，输尿管穿孔26例，输尿管粘膜损伤20例，断裂1例，术后输尿管狭窄4例，输尿管粘膜撕脱3例。结论：输尿管上段结石的并发症明显高于屮下段，嵌顿性结石的并发症也明显增高。经尿道输尿管镜气压弹道碎石术创伤小，碎石准确，安全性高。术中术后并发症的发生与输尿管的解剖及手术者的技术操作密切相关，熟悉
3、输尿管的解剖合理运用技术处理术屮情况，严格掌握手术指征，提高术屮手术技巧,可有效减少手术并发症，提高手术成功排净结石率。【关键词】输尿管结石；输尿管镜气压弹道碎石术；并发症【屮图分类号】R693+.4【文献标识码】A【文章编号】2095-1752（2015）20-0182-02Managementofcommoncomplicationsoftransureteroscopicpneumaticlithotripsyfortreatinguretercalculi(with1629casesreported
4、)JiangXiaoqin,XiaoMinhui,ShenJie(l,ClinicalMedicalCollegeofDALIUniversity6170002,DepartmentofUrology,thefirstpeople'shospitalofYunNanProvinee,Kunming,Yunnan650032).【Abstract]ObjectiveTosummarizetheprecautionarymeasuresandthecommoncomplicationsoftransureter
5、scopicpneumaticlithotripsy.Methods1629casesofuretercalculifromMay2003toOctober2014inourhospitalwereapplicatedforthetreatmentoftransureterscopicpneumaticlithotripsy,throughwhich198casesofcomplicationswereanalyzed.1208maleand421femalecases,meanage40.5years.7
6、26patientshadcalculiinthelowerureter,668casesinthemiddleureter,and235casesintheupperureter.ResultsTheoverallcomminutionratewas91.8%(1496/1629cases),198casesofcomplications,includingshiftto69casesoftherenalpelvisandstonestoESWLandotherauxiliarytreatmentof75
7、casesofresidual,26casesofureteralperforation,20casesofureteraldamage,fracturein1case,postoperativeureteralstricture,4casesofureteralmucosaavulsionin3cases.ConclusionUreteralDuanJieshicomplicationsweresignificantlyhigherthanthoseonthemiddlesection,impacteds
8、tonesinlaidcomplicationsalsoincreasedobviously.Transurethralureteroscopypneumaticballisticlithotripsysmalltrauma,gravelaccurate,highsafety・Intraoperativecomplica廿onsandpostoperativeureteralanatomyandoperation
