结石的

City of Hubei province yellow stone loves make water of health hospital secrete small start surgical department from August 2007 up to now, ureter lens of applied Switzerland EMS and ureter of cure of baric and ballistic stone crusher are calculous, give after art nurse accordingly measure, the patient recovers entirely leave hospital, obtain satisfactory result. Will nurse now experience reports as follows.

输尿管镜下气压弹道碎石术是20世纪90年代初应用于临床的泌尿外科腔内碎石新技术，其机制是将压缩气体产生的能量驱动碎石机手柄内子弹体，子弹体脉冲式冲击结石而将结石击碎，是目前治疗输尿管中、下段结石的首选治疗方法[1]。

Cholesterol gallstones formed in C57L mice and fatty livers developed in AKR mice. Conclusions Biliary cholesterol hypersecretion is the key pathophysiological defect of gallstone formation, lith genes have effects on biliary cholesterol hypersecretion and susceptibility to cholesterol gallstone formation in C57L mice. Lithogenic bile is formed at the canalicular membrane and precedes the development of cholesterol gallstones. It is most likely that cholesterol and bile acid hyposecretion make the AKR strain susceptible to the development of fatty livers and resistant to gallstone formation.

结论胆道胆固醇的高分泌是胆囊胆固醇结石形成的主要病理生理基础，结石基因决定了C57L鼠肝内胆汁中胆固醇的高分泌和胆囊胆固醇结石的易患性，成石胆汁形成在肝内胆管，先于胆囊结石的形成；肝内胆汁中胆固醇和胆酸的低分泌可能与AKR鼠脂肪肝的发生和胆囊结石的免患性有关。

METHODS:A total of 77 patients with marginal,49 with partial and 6 with complete deerhorn- like nephrolith in our department were studied retrospectively.

目的：研究低能量体外冲击波碎石(extracorpreal shock wave lihotripsy，ESWL)治疗边缘性鹿角形结石、部分鹿角形结石、完全鹿角形结石的疗效及副作用。

Objective To study the effect of biliary tract e xpansion techniquecombined with electrohydraulic lithotripsy in treating intrahepatic biliary stricture and hepatolith iasis blockage or complex hepatolithiasis.

目的总结胆道镜胆道扩张技术和液电碎石对合并有肝内胆管狭窄、胆道嵌顿结石、巨大结石复杂性肝内胆管结石的治疗效果。

objective to study the ct diagnosis of ureteral calculus at the distal end of ureter.methods 82 cases of ureteral caculus were examined by ct scanning.all cases were proved by clinical therapeutic results.results ureteral calculuses were showed as high density image in ct scanning.the ct values of the ureteral calculuses less than 7.5mm in diameter were beyond 83hu.the detection rate by ct was 96.3%.in all the 82 cases,ureteral with calculuses were found dilated and 69 cases with nephrohydrosis.in 13 cases with no nephrohydrosis,caculuses less than 3.8 mm in diameter were found.conclusion ct is the most valuable way to diagnose ureteral calculus at the lower end of ureter.appropriate methods of ct scanning are essential.

目的 回顾性分析输尿管膀胱入口处结石的ct诊断结果，评价其ct检查的临床应用价值。方法分析82例输尿管膀胱入口处结石的ct检查结果，所有病例均经尿道排石证实。结果输尿管膀胱入口处结石具有特征性的ct表现，即圆形或枣核状钙化高密度影，结石直径＜7.5mm，ct值≥83hu，ct确诊率96.3%。82例均发现病侧输尿管增粗，69例发现病侧肾盂少量积水，肾盂未见积水的输尿管膀胱入口处结石13例，其结石直径＜3.8mm。结论 ct检查输尿管膀胱入口处结石具有准确、无创、直观等优点，是诊断输尿管膀胱入口处结石不可替代的检查方法。

Results Out of the4527paˉtients treated by ESWL,stones were excreted completely from4512patients within2weeks;12patients who had comˉplication of the urethra stone street were cured by transcutaneous nephrocentesis,nephrostomy and ureterolithotomy through uretercystoscope;stones weretaken out by operation from the other3patients,from whom the excretion of stones was not possible.

目的 探讨ESWL治疗泌尿系结石的效果。方法回顾性分析经ESWL治疗的4527例泌尿系结石病人。结果经ESWL治疗的4527例泌尿系结石病人中，4512例在2周内排尽结石，12例并发输尿管&石街&，加用经皮肾穿刺造瘘和输尿管镜取石治疗，3例中转手术治疗。

Results According to the characteristic changs of ureterolithiasis, the detection rates were about 75.0%(9/l2) in the upper or middle segment and about 84.6%(11/13) in lower segment and 100%(17/17) in terminal segment.

结果 根据输尿管结石的特征性表现，超声对输尿管中上段结石的检出率约75.0%（9/12），下段结石的检出率约84.6%（11/13），末端结石的检出率100%（17/17）。

Hydrogen sodium potassium citrate can make the ureterolithiasis smaller effectively and quicken the clear-out of ureterolithiasis.It is effective and safe assistant therapeutic drugs in treating small ureterolithiasis in conservative internal medicine therapy.

枸橼酸氢钾钠能有效缩小输尿管结石，加快结石的排出，是内科保守治疗输尿管小结石安全有效的辅助治疗药物。

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。

There is a high rate of calculus symptom among people,which becomes a common and frequent sym...

结论结石症在人群中患病率高是影响人们生活质量的常见病、多发病，尿路结石患病率位于各类结石的首位。

The split between the two groups can hardly be papered over.

这两个团体间的分歧难以掩饰。

This approach not only encourages a greater number of responses, but minimizes the likelihood of stale groupthink.

这种做法不仅鼓励了更多的反应，而且减少跟风的可能性。