经输尿管镜钬激光治疗输尿管结石的临床观察

The clinical observation of ureteroscopic holmium laser lithotripsy for ureteral calculi

目的：观察输尿管镜下钬激光治疗输尿管结石的临床效果。方法对205例输尿管结石患者采用输尿管镜钬激光治疗，对排石率、并发症、碎石率进行分析。结果205例患者中198例顺利完成手术，手术时间（65．3±18．4）min，住院时间（5．6±2．7）d，手术成功率95．1％（195／205），并发症发生率11．2％（出血1例，穿孔2例，发热20例），3例结石上移至肾盂，术中留置双J管，术后行体外冲击波碎石（ ESWL ），2周至3个月复查结石完全排出，结石排净率98．4％（192／195）。7例改开放手术。术后3例输尿管残留结石及5例上移至肾盂结石均于术后行ESWL完全排出并治愈。结论输尿管镜钬激光碎石术治疗输尿管结石成功率高、排石率高、并发症少、创伤小、安全可靠。

Objective To observe the clinical effect of holmium laser for the treatment of ureteral calculi under ureteroscope .Methods In 205 cases of ureteral calculi with ureteroscopic holmium laser treatment ,the stone expulsion rate,complication,gravel rate were analyzed.Results Operation time was （65.3 ±18.4）min,hospitaliza-tion time was （5.6 ±2.7） d,the success rate of operation was 95.1%（195/205）,incidence of complications （hemorrhage in 1 cases,perforation in 2 cases,20 patients with fever） was 11.2%,3 cases of calculi moved to pel-vis,indwelling double J tube in operation ,postoperative ESWL,after 2weeks ~3months stone completely lithagogue rate was 98.4%（192/195）.7 cases converted to open operation .After operation 3 cases of ureteral calculi and 5 cases of renal pelvis stones were in postoperative ESWL （ extracorporeal shock wave lithotripsy ） , which was completely discharged and cure .Conclusion There are some advantages of ureteroscopic holmium laser lithotripsy for ureteral calculi with high success rate,the stone expulsion rate high,fewer complications,less trauma,safe and reliable.