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尿结石

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Objective:To evaluate the localization method of radiolucent ureteral calculus treated by extracorporeal shock-wave lithotripsy.

体外震波碎石在国内的泌尿系统结石治疗中已得到广泛应用,并成为治疗泌尿系统结石的首选方法。

Results of antiurolithiatic activity and safety of PGS show a good prospect on the prevention and treatment of urolithiasis.

经对PGS的抗尿路结石活性和安全性进行评价,PGS在尿路结石症的预防和治疗方面显示出了良好的应用前景。

Urolithiasis is a kind of hackneyed disease of urinary surgery. In China, especially in the South, disease rate is reach up to 1%.

泌尿系结石是最常见的泌尿外科疾病之一,在我国,尤其是南方地区,发病率高达1%,是世界上三大主要泌尿系结石流行区之一。

Due to a high incidence of urolithiasis in Taiwan, primary hyperparathyroidism should be considered in patients with hypercalcemia and recurrent urolithiasis.

目前台湾地区民众在诊断此类疾病时,合并尿路结石的比率还是偏高,所以临床医师对於不明原因的高血钙或反覆发生的尿路结石,应注意此疾病的可能性。

Percent of infected dogs were feed mainly with duck and chick livers or other animals viscus or muscle, which contained a large number of protein and ions with singular nutrition.

治疗以药物排石和手术为主,改变结石形成、生长的环境,通过药物对较大的结晶体颗粒溶解,多饮水或用速尿等促进结石随尿液排出;膀胱结石、尿道结石多采用手术取石法,但存在复发率高的缺点。

Objective: To study the effect of differe n t extracts of Alisma orientalis on urinary calcium oxalate stone formation i n rats and to identify the ef fective constituents.

中文摘要:目的:研究泽泻提取物不同组分对尿草酸钙结石形成的影响,并确定其抑制尿草酸钙结石形成的有效部位。

Results: Among these 72 patients, 14 had calculous obstruction and 58 had noncalculous obstruction.

结果:72例中诊断为结石性上尿路梗阻14例,非结石性上尿路梗阻58例。72例中有67例得到手术病理证实。

In this artical, the author reported a newly designed and manufactured extracorporeal shock wave lithotriptor, Its structure, function and clinical application were described, This is a kind of spark light dischange lithotrip-tot and may be employed without anesthesia and without immersion of pa-tients into the water, The electrodes can be used for a long period, First 30 patients of upper urolithiasis were healed with good results: stones all broken, no local subcutaneous ecchymosis, no uncomfortable feeli...

报道作者研制的体外震波碎石机的结构、性能和临床应用初步情况。该台碎石机属电极放电类型,但免除了水槽,电极寿命长,病人不用麻醉。临床首批治疗30例上尿路结石,结石均被粉碎,病员无痛苦不适,局部皮肤无灼伤、瘀血点,未见心电图异常改变,治疗后半小时至24小时开始排石。短期随访,12例于3天~30天内排尽结石,15例在继续排石中,3例肾盏结石排石量较少。取得了较满意的疗效。

Objective To study the etiology and preventive measures of urethral calculus after the urethroplasty of hypospadias.

目的 回顾25年来尿道下裂术后出现尿路结石病例,探讨尿路结石形成原因、机制及其预防措施。

objective to evaluate efficacy of extracorporeal shock wave lithotripsyfor treating ureteral stones in situ,investigate the cause of higher re-treatment rate.methods total of 687 patients with ureteral stone were received eswl between january 2000 and december 2004,included 455 male(66.2%) and 232 female(33.8%) patients,6 cases have bilateral ureteral calculi,12 cases have unilateral multiple calculi.hence,together 709 ureteral calculi were treated.patients upper ureteral calculi were treated in the supine position,for lower ureteral calculi patients were turned prone.to reduce eswl-induced renal trauma and pain,using lower energy source,adjusted power setting from 9.8 to 13.2kv,limited 1500 shock wavs per one session.no auxiliary procedure were used before eswl.the stone size was measured as the surface area of stone length by stone width on x-ray film.the interval between two treatment sessions was two weeks.results of 709 ureteral calculi,the overall stone free rate was 97.3%(690 calculi),re-treatment rate was 34.1%(292 calculi).according to the performed treatment sessions,one session 467 calculi,the mean stone size 37.27mm2,stone free rate 65.4%(464 calculi).two sessions 138 calculi,the mean stone size 62.48mm2,stone free rate 18.4%(131calculi).three sessions 52 calculi,the mean stone size 79.60mm2,stone free rate 7.1%(50calculi).four sessions 19 calculi,the mean stone size 101.63mm2,stone free rate 2.4%(17calculi).fivesessions 33 calculi,the mean stone size 119.33mm2,stone free rate 3.9%(28 calculi).overall 19 cases(2.7%)turned to other treatment modalities.of 335 upper ureteral calculi,303 achieved stone free (95.8%),re-treatment rate was 38.5%(129 calculi).of 374 lower ureteral calculi,369 achieved stone free(98.7%),re-treatment rate was 30.2%(113 calculi).the re-treatment rate of upper ureteral calculi was higher than lower ureteral calculi(p<0.05,χ2=5.40).the difference of stone-free rate between upper and lower ureteral calculi was no significant(p>0.05,χ2=0.15).conclusion eswl should be considered first line therapy for ureteral stone still.stone burden are the main variable of higher re-treatment rate,upper ureteral stone may moving with respiring during eswl.so efficinet shock wave was decreared,re-treatment rate become higher.

目的 评估体外震波碎石治疗输尿管结石的疗效,探讨再治疗率高的原因及输尿管结石的治疗选择。方法回顾2000年1月~2004年12月间eswl治疗输尿管结石的临床资料687例,男455例(66.2%),女232例(33.8%),平均年龄46.6岁(15~83岁)。有双侧输尿管结石6例,单侧多发性输尿管结石12例(4颗1例,3颗2例,2颗9例),共计输尿管结石709颗(含透光结石13颗)。应用上海爱申公司生产的desunit6030型碎石机,c臂x线球管做结石定位。上段输尿管结石(肾盂输尿管交界处至骶髂关节上缘)取仰卧位,下段输尿管结石(骶髂关节上缘下至输尿管口)取俯卧位。为减少eswl引起的肾损伤和疼痛,应用较低的能量,震波发生器电压从9.8~13.2kv,震波频率1.5s。每次治疗设定为1500次震波。治疗后3天摄腹部平片或b超,以后每隔7日重复检查。假如结石未碎或有残留结石最长径>3mm以上,再次eswl,两次治疗的间隔时间为两周。结石的大小用x线片上的表面积(mm2表示。结果 709颗输尿管结石总的治愈率为97.3%(690颗),再治疗率34.1%(242颗)。其中一次治疗467颗,平均结石大小37.27mm2,治愈464颗(65.4%),3颗改治疗;两次治疗138颗,平均结石大小62.48mm2,治愈131颗(18.5%),7颗改治疗;第1和第2次治疗治愈率(1个月治愈率)为83.8%。3次治疗52颗,平均结石大小79.60mm2,治愈50颗(7.1%),2颗改治疗;4次治疗19颗,平均结石大小101.63mm2,治愈17颗(2.4%),2颗改治疗;5次及5次以上治疗33颗,平均结石大小119.33mm2,治愈28颗(3.9%),5颗改治疗。总计19颗(2.7%)结石改变治疗方式。上段输尿管结石335颗,治愈321颗(95.8%),再治疗129颗(38.5%)。下段输尿管结石374颗,治愈369颗(98.7%),再治疗113颗(30.2%)。经χ2检验,上、下段输尿管结石的再治疗率差异有显著性(χ2=5.40,p<0.05),治愈率差异无显著性(χ2=0.15,p>0.05)。不良反应:血压升高13例(1.9%),震波区域疼痛26例(3.8%),震波进入处皮肤点状淤血33例(4.8%),肉眼血尿128例(18.6%),均于第2、3天自行消失。结论 eswl目前仍是输尿管结石的第一线治疗,结石的大小是再治疗率高的主要因素。结石的位置有影响,上段输尿管结石可随呼吸移动,有效震波次数减少,再治疗率比下段输尿管结石高。eswl前注重病例筛选可降低再治疗率。

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