输尿管开口囊肿、狭窄及膀胱颈部挛缩的HO:YAG激光治疗

Holmium Laser Resection of the Ureter Cyst,Stricture and Bladder Neck Contracture

目的 :利用 HO:YAG激光的软组织切割及止血作用 ,对输尿管开口囊肿、狭窄及膀胱颈部挛缩的患者行激光治疗 ,并观察疗效。方法 :采用 HO:YAG激光对 6例输尿管开口囊肿 ,15例输尿管开口狭窄 (其中 3例合并输尿管结石 ) ,32例膀胱颈部挛缩进行治疗 ,观察术中出血、术后并发症、膀胱挛缩患者手术前后 Qmax。结果 :总计5 3例患者通过 HO:YAG激光治疗 ,均获得满意临床疗效 ,术中几乎无出血 ,输尿管开口囊肿及狭窄患者 ,术毕能顺利留置 F7双猪尾巴导管。膀胱颈部挛缩患者术后最大尿流率提高了 7.6ml/ s(7.2～ 14 .8ml/ s)。结论 :HO:YAG激光对输尿管开口囊肿、狭窄及膀胱颈部挛缩是一种行之有效的治疗方法 ,且无出血 ,易于操作、安全、恢复快。尤其是输尿管结石合并输尿管开口狭窄患者 ,可通过 HO:YAG激光一次手术解决。

Objective: Toussess the early efficacy and safety of holmium laser resections of the ureter stricture, bladder neck contracture. Methods :A total of 53 patients underwent 53 procedures including incision of ureter stricture and bladder neck contracture .The resection time, holmium energy use, catheter retention time and hospital stay were all recorded. Results: Procedures were considered successful, with no severe complications such as hematuria.The mean Qmax increased from 7.2ml/s to 14.8ml/s after 3 months. Conclusions: The HO:YAG laser demonstrates precise hemostatic cutting and warrants further investigation as a multipurpose urologic laser.