输尿管软镜下钬激光碎石术在复杂上尿路结石治疗中的应用效果

Application effect of flexible ureteroscope holmium laser lithotripsy in the treatment of complex upper urinary tract calculi

目的对输尿管软镜下钬激光碎石术在复杂上尿路结石治疗中的应用效果进行分析和探讨。方法对42例复杂上尿路结石患者的临床资料进行回顾性分析。所有患者均接受输尿管软镜下钬激光碎石治疗,先通过输尿管软镜探查到结石的位置,然后采用365μm光纤,100 W+钬激光进行碎石治疗。术后2个月到医院进行复查。结果 42例患者共有45枚结石,结石的探寻准确率为100.0%(42/42),术后2个月复查结果显示34例患者结石均全部排净,单次碎石成功率为81.0%(34/42);本组患者中无一例出现大出血、感染性休克以及输尿管穿孔等严重并发症。结论输尿管软镜下钬激光碎石术应用于复杂上尿路结石治疗中可准确探寻到结石的位置,并对其进行彻底碎石,成功率高,且并发症的发生率小,是一种安全、有效的方法。

Objective To analyze and investigate the application effect of flexible ureteroscope holmium laser lithotripsy in the treatment of complex upper urinary tract calculi. Methods A retrospective analysis was made on the clinical data of 42 patients with complex upper urinary tract calculi. They all received flexible ureteroscope holmium laser lithotripsy for treatment. Calculi location was searched by flexible ureteroscope, and 100 W＋holmium laser with 365μm optical fiber was applied for lithotripsy. Reexamination was taken in 2 months after operation. Results All the 42 patients had totally 45 pieces of calculi, and the accuracy of calculi was 100.0%（42/42）. Reexamination after 2 months showed that there were 34 patients with all cleared calculi, and their single success rate of lithotripsy was 81.0%（34/42）. No patients had severe complications as massive haemorrhage, septic shock, and ureteral perforation. Conclusion Application of flexible ureteroscope holmium laser lithotripsy can accurately show location of complex upper urinary tract calculi, and it can thoroughly crush calculi with high success rate and low incidence of complications. This method is safe and effective.