取石网篮在输尿管镜下钬激光碎石术治疗上段输尿管结石中的应用

Application of stone basket in ureteroscopic holmium laser lithotripsy for treatment of upper ureteral calculi

目的：探讨取石网篮在输尿管镜下钬激光碎石术治疗上段输尿管结石中的应用效果。方法回顾性分析96例输尿管上段结石患者的临床资料，均行输尿管镜下钬激光碎石术治疗，其中术中应用取石网篮48例（观察组），术中未应用取石网篮48例（对照组）。比较两组患者的手术时间、住院时间、碎石成功率、结石残留率和并发症发生率。结果两组患者均顺利完成手术。两组手术时间、住院时间和术后并发症发生率比较差异无统计学意义（P＞0.05）。观察组碎石成功率明显高于对照组[97.92%（47/48）比75.00%（36/48）]，结石残留率明显低于对照组[4.17%（2/48）比18.75%（9/48）]，差异有统计学意义（P＜0.05）。结论在输尿管镜下钬激光碎石术治疗上段输尿管结石术中使用取石网篮可更彻底地清除结石，减少结石残留率，且不影响手术的安全性，具有良好的临床应用价值。

Objective To investigate the application effect of stone basket in ureteroscopic holmium laser lithotripsy for treatment of upper ureteral calculi. Methods The clinical data of 96 patients with upper ureteral calculi were retrospectively analyzed, all patients underwent ureteroscopic holmium laser lithotripsy. Forty-eight cases used the stone basket in the operation process （observation group）, and 48 cases did not use the stone basket in the operation process （control group）. The operation time, length of stay, success rate of lithotripsy, stone residual rate and incidence of postoperative complication were compared between 2 groups. Results The patients of 2 groups successfully completed surgery. There were no statistical differences in operation time, length of stay and incidence of postoperative complication between 2 groups （P〉0.05）. The success rate of lithotripsy in observation group was significantly higher than that in control group： 97.92% （47/48） vs. 75.00% （36/48）, and the stone residual rate was significantly lower than that in control group：4.17%（2/48） vs. 18.75%（9/48）, and there were statistical differences （P〈0.05）. Conclusions The stone basket in ureteroscopic holmium laser lithotripsy for treatment of upper ureteral calculi can thoroughly remove stones. It reduces the incidence of residual stones, does not affect the safety of the operation, and has good clinical value.