摘要
目的探讨黏膜表面麻醉下行输尿管镜下气压弹道碎石的可行性及安全性。方法采用尿道黏膜表面麻醉行输尿管镜下气压弹道碎石,共214例,其中男95例,女119例。上输尿管结石28例,中下段结石186例,结石横径3～10mm,纵径5～32mm。结果单次碎石成功率86.4%(185/214),上段64.3%(18/28),中下段89.8%(167/186),10例术中因不能耐受疼痛而加用止痛药(哌替啶),其中8例缓解,2例止痛效果不明显改连续硬脊膜外阻滞麻醉,术中置镜失败6例,输尿管穿孔2例,发热5例,术后并发症主要为血尿。结论尿道黏膜表面麻醉下行输尿管镜气压弹道碎石安全可行,降低了治疗费用及术前准备时间,减少其他麻醉方式可能引起的并发症。
[Objective] To evaluate transureterscopic pneumatic lithotripsy under local anesthesia in the treatment of the ureteral calculi. [Methods] 214 cases of ureteral calcoli were treated with ureteroscopic pneumatic lithotripsy under local anesthesia. There were 95 male patient and 119 female, 28 cases had upper ureteral stone, and 186 cases had middle and lower ureteral stone. The transverse diameter of the stones was 3-10 mm, and the vertical length was 5-32 mm. [Result] Stones were successfully fragmented on the first session in 86.4% of patient （185/214）, The success rate was 64.3% in patients with stones in the upper ureteral segment（18/28） and 89.8% in patients with stones in the middle and lower ureteral segment （167/186）, 10 cases could not endure the pain during the operation and received analgetic pethidine. 8 cases relaxed and 2 cases did not and changed to continuous epidural anesthesia. The main complications in operation were failure to insert the ureteroscope in 6 cases and ureteral perforations in 2 case and post-operation were mainly hematuria. [Conclusion] Treatment of ureteral calculi by transureterscopic pneumatic lithotripsy under local anesthesia is safe and effective. It reduces the cost of the treatment and the time preparing for operation and the complication associated with other anesthesia.
出处
《中国内镜杂志》
CSCD
北大核心
2007年第10期1082-1083,1086,共3页
China Journal of Endoscopy
