Segura J W, Preminger G M, Assimos D G, Dretler S P, Kahn R I, Lingeman J E, Macaluso J N
J Urol. 1997 Nov;158(5):1915-21. doi: 10.1016/s0022-5347(01)64173-9.
The American Urological Association convened the Ureteral Stones Clinical Guidelines Panel to analyze the literature regarding available methods for treating ureteral calculi and to make practice policy recommendations based on the treatment outcomes data.
The panel searched the MEDLINE data base for all articles related to ureteral calculi published from 1966 to January 1996. Outcomes data were extracted from articles accepted after panel review. The data were then meta-analyzed to produce outcome estimates for alternative treatments of ureteral calculi.
The data indicate that up to 98% of stones less than 0.5 cm. in diameter, especially in the distal ureter, will pass spontaneously. Shock wave lithotripsy is recommended as first line treatment for most patients with stones 1 cm. or less in the proximal ureter. Shock wave lithotripsy and ureteroscopy are acceptable treatment choices for stones 1 cm. or less in the distal ureter.
Most ureteral stones will pass spontaneously. Those that do not can be removed by either shock wave lithotripsy or ureteroscopy. Traditional blind basket extraction, without fluoroscopic control and guide wires, is not recommended. Open surgery is appropriate as a salvage procedure or in certain unusual circumstances.
美国泌尿外科学会召集输尿管结石临床指南小组，分析有关输尿管结石现有治疗方法的文献，并根据治疗结果数据提出实践政策建议。
该小组在MEDLINE数据库中检索了1966年至1996年1月发表的所有与输尿管结石相关的文章。结果数据从小组审查后接受的文章中提取。然后对数据进行荟萃分析，以得出输尿管结石替代治疗的结果估计。
数据表明，直径小于0.5厘米的结石，尤其是输尿管远端的结石，高达98%会自行排出。对于大多数近端输尿管结石直径为1厘米或更小的患者，推荐冲击波碎石术作为一线治疗方法。对于远端输尿管结石直径为1厘米或更小的患者，冲击波碎石术和输尿管镜检查都是可接受的治疗选择。
大多数输尿管结石会自行排出。那些不能自行排出的结石可以通过冲击波碎石术或输尿管镜检查取出。不建议在没有荧光透视控制和导丝的情况下进行传统的盲目篮式取石术。开放手术适合作为挽救手术或在某些特殊情况下使用。
