U100plus激光碎石术治疗输尿管结石605例疗效观察

Observation of the Treatment of 605 Cases with Ureteric Stones by U100plus Laser under Ureteroscope

目的探讨输尿管镜下U100plus激光碎石治疗输尿管结石的临床疗效和手术方法。方法对605例输尿管结石患者在输尿管镜下应用U100plus激光进行碎石治疗。结果输尿管结石碎石成功率为94.5%(572/605),其中上段结石成功率为90.0%(54/60),中段成功率为94.8%(273/288),下段成功率为95.3%(245/257)。手术时间12～45min,平均27min,平均激光工作时间(6.5±3.5)min,平均10d(2～19d)排净结石,术后平均住院5d(1～8d)。45.1%(273/605)的患者术后均有不同程度的肉眼血尿,对症处理后2～4d消失。6例上段碎石返流入肾盂内,需辅以冲击波碎石;开展初期发生输尿管损伤输尿管穿孔者5例,均行开放手术治疗;22例输尿管镜插入失败,放弃腔内碎石;无输尿管撕脱、脓肾等并发症。结论U100plus激光是一种安全、高效的腔内泌尿外科碎石方法。

Objective To research the results of the treatment of ureteral stones by U100plus laser under ureteroscope. Methods 605 cases of ureteral stones were treated with ureteroscope U100 plus laser lithotritor. Results The successful rate was 94.5%（572/605）in the proximal calculi, 90.0%（54/60）in the middle ureteral calculi, 94.8%（273/288）in the distal ureteral calculi. The average time for operation was 27 minutes（ 12 - 45min）and（6.5 ± 3.5 ）minutes for the laser. The time for stone expectoration was 10（2 - 19）days. The time for post operation hospitalization was 5 （ 3 - 7 ）days. Different degree of hematuria were seen in 45.1% （ 273/605 ） cases after operation. 6 cases needed auxiliary ESWL for fragment expelling. 5 cases suffered ureter icinjuries and 5 cases needed open operation. In 22 cases failure to insert ureterroscope, gave up the process. No major complications such as high fever,perforation or Ureteric pyonephrosis were observed. Conclusion U100 plus laser under ureteroscope is an effective, simple and reliable method for the treatment of ureteral calculi.