经输尿管镜钬激光碎石治疗输尿管结石164例

Holmium laser lithotripsy under ureteroscope for ureteral calculi:report of 164 cases

目的探讨经输尿管镜钬激光碎石治疗输尿管结石的临床效果。方法164例输尿管结石病例。经尿道、膀胱置入F8输尿管镜抵迭结石处，将激光纤头直抵结石，设置工作能量0．8～1．0J，频率8～10Hz，采用连续脉冲方式粉碎结石。结果8例进镜失败、2例输尿管穿孔及1例结石移位改行开放手术；148例碎石成功，单次手术结石粉碎率为94．6％（140／148）。手术时间10～100min，平均（40．8±13．6）min；术后住院时闻1～9d，平均（2．7±1．5）d。随访2～4周后结石排净率为96．2％。结论经输尿管镜钬激光碎石治疗输尿管结石在直视下操作，可同时处理输尿管息肉，碎石疗效确切、安全，并发症少。

Objective To evaluate the clinical results of holmium laser lithotripsy under ureteroscope for the treatment of ureteral calculi. Methods A total of 164 cases of ureteral calculi were included in the study. A F8 ureteroscope was advanced through the urethra and bladder with its tip touching the stone. Holmium laser pulse radiation with a pulse energy of 0.8- 1.0J and repetition rates, of 8-10Hz was focused into the stones. Results Conversions to open surgery were required in 11 cases because of failed ureteroscope insertion（8 cases）, ureteral perforation （2 cases）, or stones moved （ 1 caes）. Holmium laser lithotripsy was successfully completed in 148 cases,and the success rate of one session was 94. 6 % （140/148）. The operation time was 10-100min [（40.8±13.6）min], and the postoperative hospital stay, 1- 9d[（2.7 ± 1.5）d]. Follow-up for 2- 4 weeks revealed a stone-free rate of 96.2%, Conclusion Holmium laser lithotripsy under ureteroscope for ureteral calculi worked by the way of euthyphoria could cut polyp of ureter at the same time,and it is effective,mini-invasive and safe.