Hosking D H, Bard R J
Department of Surgery, University of Manitoba, Winnipeg, Canada.
J Urol. 1996 Sep;156(3):899-901; discussion 902.
We evaluated the safety, efficacy and patient tolerance of ureteroscopy with intravenous sedation for treatment of distal ureteral calculi.
Ureteroscopy with intravenous sedation was performed in 68 patients, with small distal ureteral calculi requiring treatment and in 2 with middle or upper third ureteral calculi. Intravenous sedation and analgesia were achieved with a combination of fentanyl and midazolam. Balloon dilation of the ureter was performed in 38 patients. Ureteroscopy was performed with a 6F rigid ureteroscope.
Stone removal was successful in 66 patients (97%). There were no ureteral perforations in patients undergoing successful stone removal and no complications related to intravenous sedation. Tolerance of the procedure was good in 81% of the patients (including 72% of 36 men and 94% of 32 women undergoing ureteroscopy for distal ureteral calculi) and fair in 19%.
In select patients with small distal ureteral calculi ureteroscopy offers a safe, effective and well tolerated alternative to shock wave lithotripsy.
我们评估了静脉镇静下输尿管镜检查治疗远端输尿管结石的安全性、有效性及患者耐受性。
对68例需要治疗的远端输尿管小结石患者及2例输尿管中、上段结石患者进行了静脉镇静下输尿管镜检查。通过芬太尼和咪达唑仑联合使用实现静脉镇静和镇痛。38例患者进行了输尿管球囊扩张。使用6F硬性输尿管镜进行输尿管镜检查。
66例患者（97%）结石清除成功。结石清除成功的患者未发生输尿管穿孔，也没有与静脉镇静相关的并发症。81%的患者对该操作耐受性良好（包括36例接受远端输尿管结石输尿管镜检查的男性患者中的72%和32例女性患者中的94%），19%的患者耐受性一般。
对于选定的远端输尿管小结石患者，输尿管镜检查为冲击波碎石术提供了一种安全、有效且耐受性良好的替代方法。
