输尿管硬软镜联合治疗复杂性输尿管上段结石

Treatment of complicated upper ureteral calculi with rigid ureteroscope and flexible ureteroscope

目的:探讨输尿管硬软镜双镜联合治疗复杂输尿管上段结石的疗效及安全性。方法:回顾性分析62例复杂输尿管上段结石行输尿管硬、软镜联合治疗的手术效果。结果:62例均应用输尿管镜碎石,35例有较大块结石逃逸进入肾脏,应用输尿管软镜进一步碎石成功,总的结石清除率96.8%,手术时间25~70 min,术后住院时间2 d,无输尿管穿孔、撕脱,无感染性休克发生,无输血病例。结论:输尿管硬软镜双镜联合治疗复杂输尿管上段结石安全有效,结石粉碎率高、结石排净率高、并发症少、住院时间短。

Objective： To evaluate the efficacy and safety rigid ureteroscope and flexible ureteroscope in treatment of complicated upper ureteral calculi.Methods： The operative outcomes were reviewed in 62 cases of complicated upper ureteral calculi treated with rigid ureteroscope and flexible ureteroscope.Results： Of the 62 patients received rigid ureteroscopic lithotripsy,escaping of the large stones into the kidney occurred in 35,and was successfully managed with flexible ureteroscope lithotripsy.The total stone-free rate was 96. 8%,and average operative time was 50 min. Postoperative hospital stay was 2days on average.No incidence,including ureteral perforation,avulsion,septic shock and blood transfusion,occurred.Conclusion： Treatment of upper ureteral calculi can be safe and effective with rigid ureteroscope plus flexible ureteroscope,and leads to higher lithotriptic rate and stone-free rate as well as fewer complications and shorter postoperative stay.