U100双频双脉冲激光治疗输尿管结石(附260例报告)

Treating ureteral calculi with U100 frequency-doubled double pulse Nd∶ YAG laser (Report of 260 cases)

目的:探讨U100双频双脉冲掺钕钇铝石榴石(Nd∶YAG)激光(FREDDY技术)治疗输尿管结石的临床疗效。方法:应用U100双频双脉冲Nd∶YAG激光经内腔镜治疗输尿管结石260例,其中结石位于上段58例,中段157例,下段45例,其中67例伴有BPH,术前行ESWL者61例。结果:输尿管结石碎石成功率为96.5%(251/260),其中上段结石成功率为93.1%(54/58),中段成功率为97.4%(153/157),下段成功率为97.8%(44/45),三组结果比较差异无统计学意义(P>0.05)。平均手术时间25(7～45)min,平均激光工作时间(5.5±3.5)min,平均12(2～21)天排净结石,术后平均住院2.5(1～6)天。43.1%(112/260)的患者术后均有不同程度的肉眼血尿,对症处理后2～4天消失。无输尿管穿孔、撕裂、感染、脓肾等并发症。结论:FREDDY激光碎石手术时间短,组织损伤小,术后并发症少,是一种安全、高效的腔内泌尿外科碎石方法。

Objective： To evaluate the clinical effect of U100 frequency-doubled double pulse Nd： YAG laser lithotripsy for ureteral calculi. Methods：Totally 260 cases with ureteral calculi treated via endoscope with FREDDY was summarized. Results.-The successful rate was 93.1%（54/58） in the proximal ureteral calculi, 97.4% （153/ 157） in the middle ureteral calculi, 97.7%（44/45） in the distal ureteral calculi and 96.5%（251/260） in all. There was no difference among the 3 groups（ P 〉0.05）. The meantime of operation was 25 minutes（7～45 min） and the laser worked （ 5.5± 3.5 ） minutes in average. The stone expectoration time was 12 （ 2 ～21 ） days. The mean post operation hospitalization was 2.5 （1 ～ 6 ）days. Different degrees of hematuria were seen in 43.0% （112/260 ） cases after operation. No major complications such as high fever, perforation or pyonephrosis were observed. Conclusions： FREDDY is a kind of laser with little damage to the soft tissue and high efficiency of lithotripsy. It is an effective, simple and reliable method for the treatment of ureteral calculi.