拦石网在输尿管镜钬激光碎石术治疗上段输尿管结石中的应用

Application of intercept stone network in treatment of upper ureteral calculi with holmium laser lithotripsy under ureteroscope

目的探讨拦石网在输尿管镜钬激光碎石术治疗输尿管上段结石中的临床应用价值。方法将165例输尿管上段结石患者随机分为对照组(79例)和实验组(86例),2组均采用硬性输尿管镜和钬激光碎石术:对照组术中不联合使用拦石网;实验组术中配合应用拦石网。结果结石被推回或被冲回肾盂或肾盏内共15例:实验组2例,对照组13例。实验组单次碎石成功率98%,高于对照组的84%,P<0.01。2组术中均无输尿管穿孔等明显并发症发生。结论在输尿管镜钬激光碎石术治疗上段输尿管结石中联合使用拦石网固定结石后再碎石的方法,可阻止结石被推回或被冲回,从而提高输尿管上段结石的碎石成功率。

Objective It is to approach the clinical application value of intercept stone network in the treatment of upper ureteral calculi with holmium laser lithotripsy under ureteroscope. Methods 165 patients with upper ureteral calculi were randomly divided into two groups. 79 cases were in control group and treated with rigid ureteroscope and holmium laser lithotripsy but no intercept stone network. 86 cases were in experimental group and treated with intercept stone network based on control group. Results The calculi pushed back or reversed to renal pelvis or renal calices in 15 cases in which there were 13 cases in control group and 2 cases in experimental group. The one kick broken stone achievement ratio in experimental group was 98 % and was higher than that in control group in which there was 84 % （P 〈 0.01）. There was no obvious complications such as ureteric perforation occurred during the operation in the two groups. Conclusion Combined with intercept stone network fixing calculi and then breaking stone in the treatment of upper ureteral calculi with holmium laser lithotripsy under ureteroscope can prevent the calculi pushed back or reversed, and then can heighten the calculi fragmentation successful rate of upper ureteral calculi.