输尿管镜钬激光碎石术治疗输尿管结石

Treatment of Ureteral Calculi with Transureteroscopic Holmium:YAG Laser Lithotripsy

目的:探讨输尿管镜钬激光碎石术治疗输尿管结石的有效性和安全性。方法:回顾性分析216例应用经输尿管镜钬激光碎石术治疗的输尿管结石患者资料。男133例,女83例;年龄20～68岁,平均49岁。上段结石48例,中段58例,下段110例。结石直径0.7～2.6cm,平均1.4cm。结果:单次碎石成功率为98.1%(212/216),其中上段结石单次碎石成功率为91.6%(44/48),中、下段为100%(168/168)。平均手术时间29min,212例术后平均住院3.5天。术后随访2周～3个月,结石排净率99%(210/212)。结论:输尿管镜钬激光碎石术治疗输尿管结石高效、安全,可作为输尿管结石特别是中下段结石首选的治疗方法。

Objective：To evaluate the efficacy and safety of ureteroscopic lithotripsy with holmium ： YAG laser for treatment of ureteral calculi. Methods：We retrospectively reviewed the data of 216 patients （133 males and 83 females, with an average age of 49 years） who underwent ureteroscopic lithotripsy using holmium ： YAG laser. Among these cases, 48 cases had stones in the upper, 58 cases in the middle, and 110 cases in the lower ureter. The stones were 0.7 to 2.6 cm （mean 1.4 cm） in diameter. Results：The overall rate of successful fragmentation for all levels of ureteratstones in a single procedure achieved 98.1% （212/216）. The success rates of fragmentation in a single procedure for the upper and mid-lower levels of ureteral stones were 91.6% （44/48） and 100% （168/168）, respectively. The mean operative time was 29 min, and the mean postoperative hospital stay of 212 cases was 3.5 days. In 212 patients, the postoperative follow up of 2 weeks to 3 months revealed that the stone free rate was 99% （210/212） . Conclusions：Transureteroscopic holmium ： YAG laser lithotripsy is a highly effective and safe therapy for patients with ureteral calculi. It can be considered as a first choice of treatment, especially for those with middle or lower levels of ureteral stones.