斜卧-截石位输尿管镜下钬激光碎石治疗输尿管上段结石的疗效观察

Curative effect observation of recumbent-lithotomy position ureteroscopic holmium laser lithotripsy in the treatment of upper ureteral calculi

目的：探讨斜卧-截石位输尿管镜下钬激光碎石治疗输尿管上段结石的临床效果。方法回顾性分析98例输尿管上段结石患者施行斜卧-截石位输尿管镜下钬激光碎石术的临床资料。结果手术时间28-83 min,平均手术时间（45.9±5.7）min。98例中首次碎石成功率为90.8%（89/98）。2例因输尿管管腔严重狭窄、1例因输尿管扭曲严重改行开放手术。6例（6.1%）结石残留,结合体外冲击波碎石术（ESWL）治疗后结石排尽。无严重并发症发生。结论斜卧-截石位经输尿管镜钬激光碎石术具有创伤小、操作简单、疗效确切、术后恢复快等优点,是治疗输尿管上段结石的一种安全、有效的方法。

Objective To explore the clinical effect of recumbent-lithotomy position ureteroscopic holmium laser lithotripsy in the treatment of upper ureteral calculi. Methods A retrospectively analysis was made on the clinical data of 98 upper ureteral calculi patients, who underwent recumbent-lithotomy position ureteroscopic holmium laser lithotripsy. Results The operation times were 28-83 min, with an average time of （45.9±5.7） min. Among the 98 cases, the first time success rate of lithotripsy was 90.8%（89/98）. Open operations were applied, instead of lithotripsy, on 2 cases with severe ureteral lumen stenosis and 1 case with severe ureteral distortion. There were 6 cases （6.1%） with residual calculi, which were completely cleared by extracorporeal shock wave lithotripsy （ESWL）. No severe complications occurred. Conclusion The method of recumbent-lithotomy position ureteroscopic holmium laser lithotripsy has the advantages of small trauma, simple operation, precise effect, and quick recovery. It is a safe and effective treatment of upper ureteral calculi.