Simon J, Roumeguere T, Vaessen C, Schulman C C
Department of Urology, Erasme Hospital, Brussels University Clinics, Belgium.
Acta Urol Belg. 1997 Jun;65(2):7-9.
The authors review the current conservative management of ureteric stones. The physiopathology of the renal colic is analyzed with its implications in the medical treatment. The role of NSAID is enhanced. Stone size and stone location are to be considered when evaluating the possibility of spontaneous passage of the stone. Stones less than 3 mm in diameter of the lower ureter will pass spontaneously in 90% of the cases while stones more then 6 mm in the upper ureter will not pass in most cases. The role of stone dissolution in uric acid and cystine stones is discussed. SWL is not controversial in the management of upper stones less than 15 mm in size. The authors report their experience with SWL of ureteric stones in upper, middle or lower ureteric stones with a success rate of respectively 87%, 65% and 84%.
作者回顾了目前输尿管结石的保守治疗方法。分析了肾绞痛的生理病理学及其在药物治疗中的意义。非甾体抗炎药(NSAID)的作用得到了强化。在评估结石自然排出的可能性时,需要考虑结石大小和结石位置。直径小于3mm的下段输尿管结石90%可自然排出,而直径大于6mm的上段输尿管结石大多数情况下不会自然排出。讨论了尿酸结石和胱氨酸结石的溶石作用。对于直径小于15mm的上段结石,体外冲击波碎石术(SWL)在治疗中并无争议。作者报告了他们对输尿管上段、中段和下段结石进行SWL的经验,成功率分别为87%、65%和84%。