输尿管镜下钬激光碎石术治疗输尿管结石(附96例报告)

Treatment of ureteral calcui with transureteroscopic holmium:YAG Laser lithotripsy(report of 96 cases)

目的探讨经输尿管硬镜钬激光治疗输尿管结石的有效性及安全性。方法回顾性分析96例应用硬性输尿管镜钬激光治疗的输尿管结石患者资料(男性57例,女性39例;平均年龄41岁)。输尿管上段结石36例,中段结石24例,下段结石36例。结石直径0.5～2.5cm,平均1.1cm。结果单次碎石成功率为94.7%(91/96),其中上段结石单次手术碎石成率达90%(32/36),其中3例因术中结石移位入肾盂,留置双J管后行ESWL治疗,1例因结石下方输尿管扭曲改行开放手术。输尿管中下段结石一次碎石成功率为为98%(59/60),一例因输尿管狭窄改行开放手术。平均手术时间38min,术中未发生输尿管穿孔、黏膜撕脱等并发症。91例术后平均住院时间3.2d。术后随访3周～2个月,结石排净率98%(89/91)。结论输尿管镜钬激光碎石术是一种治疗输尿管结石安全、高效的方法。

[Objective] To evaluate the efficacy and safety of transureteroseopie holmium laser in management of ureteral calculi. [Methods] We retrospectively reviewed the data of 96 patients （57 males and 39 females, with an average age of 41 years）. Among these cases, 36 had stones in the upper, 34 in the middle, and 26 in the lower ureter. The stones were 0.5～2.5 em （average 1.1 era） in diameter. [Results] The overall rate of successful fragmentation for all levels of ureteral stones in a single procedure achieved 94.7%. Success rate of fragmentation in single procedure for the upper level of ureteral stones was 90% （32/36）, of which 1 ease shifted to open operation and the other 3 eases underwent auxiliary extraeorporeal shock wave lithotripsy afterwards. Success rate of fragmentation in single procedure for the mid-lower level of ureteral stones was 98% （59/60）, and 1 ease shifted to open operation because of ureteral stricture. The average operative time was 38 rain, and the mean postoperative hospital stay was 3.2 days. The postoperative follow-up of 3 weeks to 2 months revealed that stone-free rate was 98% （89/91）. [Conclusions] Thetransureteroseopie holmium： YAG laser lithotripsy is an effective and safe therapy for patients with ureteral calculi.