急诊输尿管镜钬激光碎石治疗输尿管结石急性梗阻

Transureteroscope holmium laser in treatment of acute obstruction by ureteral calculus

目的探讨急诊经尿道输尿管镜钬激光碎石取石解除输尿管结石嵌顿致肾后急性梗阻治疗方法的可行性。方法对14例结石嵌顿于输尿管中下段导致持续性肾绞痛超过24h、体温不降甚至继续升高、感染难以控制、肾功能损害患者,经过必要的术前准备,急诊施行经尿道输尿管镜碎石取石、输尿管放置双J管内引流术,及时解除梗阻,引流尿液。结果所有患者顺利接受手术,14例中下段结石获得了彻底粉碎;术后患者疼痛立即消失、体温降至正常、感染控制、全身状况改善、肾功能及时恢复。无1例出现脓肾、肾功能衰竭等严重并发症。全部于术后2周内排尽碎石。结论急诊经尿道输尿管镜钬激光碎石取石术的解除输尿管结石性梗阻便捷、安全、有效,具有很强的实用性及可操作性,值得推广。

Objective To evaluate the emergency treatment on acute obstruction of impacted ureteral calculus by transureteroscope holmium laser. Methods 14 cases of patients impacted ureteral calculus, with durative kidney angina for 24 hours, with renal infections, with no pyelic imaging in travenous pyelogram in obstructed side and renal function damaged, were treated emergency by ureteroscopic lithotomy and ureter catherizing after careful pre-operative preparing,in order to wipe off obstruction and pain, urinary drainage and save renal function. Results All patients were successfully underwent the operation. 14 sides mid and distal ureteral calculus were successfully treated. After operation, all patients＇ pain disappear, health improved, renal function improved quickly, infections and other syndrome were controled in time, and there was no serious syndrome, such as pyonephrosis and renal function loss. 14 cases of patients with ureteral calculi were successfully treated after 2 weeks. Conclusion Transureteroscope holmium laser is a effective, convenient and safe method for treatment on impacted ureteral calculus.