钬激光治疗输尿管梗阻的应用疗效

The Efficacy of Holmium Laser on Ureteral Obstruction

目的探讨输尿管梗阻患者在输尿管镜下行钬激光内切开术治疗的效果。方法将该院2012年1月—2013年5月收治的25例输尿管梗阻患者作为研究对象,采用输尿管镜下钬激光内切开术治疗,并对治疗效果进行观察分析。结果 25例患者经过输尿管镜下行钬激光内切开术治疗后,效果明显,手术平均时间为(31.4±3.5)min;手术失败1例,余24例平均随访10.6个月,有1例出现肾脏无功能继发难治性感染而进行了肾切除,剩余23例患者的肾功能得以明显改善,患侧的肾小球滤过率术后显著升高,数值比较差异有统计学意义(P<0.01);随访期患者皆未出现复发现象。结论对输尿管梗阻患者采用输尿管镜下行钬激光内切开术治疗,创伤小、并发症较少、术后不易复发,是一种有效且安全的微创术式,值得临床上进行推广及应用。

Objective To investigate the therapeutic effect of transureteroscopic holmium laser intemai incision on ureteral obstruction. Methods 25 patients with ureteral obstruction admitted in our hospital from January, 2012 to May, 2013 were selected as the subjects and treated with ureteroscopic holmium laser incision. And the efficacy of the operation was observed and analyzed. Results The transureteroscopic holmium laser internal incision surgeries of the 25 patients were quite effective. The mean operative time was （31.4 ~ 3.5） minutes. The surgery failed in 1 case. The other 24 cases were fol/owed up for 10.6 months on average, of whom, 1 case underwent nephrectomy because of secondary refractory infection caused by renal dysfunction. The remaining 23 cases＇ renal function improved significantly, the postoperative ipsilateral glomerular filtration rate of them was much higher than that before the operation, the difference was statistically significant （P〈0.01）. And no recurrence occurred during the follow-up period. Conclusion For the patients with ureteral obstruction, transureteroscopic holmium laser internal incision is an effective and safe minimally invasive surgery with smaller trauma, fewer complications and lower postoperative recurrence rate, which is worthy of clinical promotion and application.