输尿管镜下钬激光碎石术治疗输尿管结石32例临床分析

Experience of holmium laser lithotripsy for ureteric stones in 32 cases

目的探讨输尿管镜下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32例应用经输尿管镜钬激光碎石术治疗的输尿管结石患者的临床资料。其中男15例，女17例；年龄24～67岁，平均48岁。上段结石10例，中下段22例；结石直径0．6—1．9em，平均1．0cm。应用不同的进镜方法和冲水方法，注意进镜技巧和碎石技巧。结果32例中30例手术顺利完成，2例改开放手术。进镜成功率为100％（32／32），碎石成功率为100％（30／30）。平均手术时间50min，术后平均住院4d。术后随访1个月～1年。单纯钬激光碎石结石排净率93．3％（28／30）。2例因肾脏结石残留行体外冲击波碎石治疗，2周后结石清除。结论输尿管镜钬激光碎石术治疗输尿管结石高效、安全，可作为输尿管全程结石首选的治疗方法。

Objective To investigate the effectiveness and security of holmium laser lithotripsy for ureteric stone. Methods A retrospective analysis of 32 patients with uretecic stones and treated by holmium laser lithotripsy was done. Fifteen males and 17 females were included, 24 to 67 years old, an average of 48 years old. The number of upper segments stones was 10 cases, middle-lower segments was 22 cases. The stone diameter was 0.6 to 1.9 cm, an average of 1.0 cm. Different methods of entring ureteroscope and flush were applied. Attention of kills about entring ureteroscope and lithotripsy were paid. Results Thirty cases operated successfully, 2 cases converted to open surgery in 32 cases. The entry rate of ureteroscope was 100% （32/32）, the rate of breaking stone was 100% （30/30）. The mean operative time was 50 min, mean day in hospital in postoperation was 4 days. One month to 1 year was followed-up. Complete lithagogue rate of using holmium laser lithotripsy was 93.3% （28/30）. Two cases dued to the residually renal stones were treated with ESWL, stones were discharged 2 weeks later. Conclusions The holmium laser lithotripsy for ureteral stones is efficient and safe, can be used as the preferred method of treating full ureter stones.