封堵器在输尿管镜下输尿管上段结石碎石中的应用

Application of Occluder in Ureteroscopic Lithotripsy for Upper Ureteral Calculi

目的:探讨防止输尿管上段结石上移,提高输尿管上段结石治疗成功率的方法。方法:对138例输尿管上段结石患者在进行输尿管镜下钬激光或气压弹道碎石中应用封堵器进行治疗。结果:132例一次治疗结石排除,6例部分结石上移至肾脏,术后配合ESWL经药物治疗后排出。结论:在输尿管镜下钬激光或气压弹道碎石中应用封堵器,可减少输尿管上段结石碎石术中结石上移,提高碎石及清石率,缩短手术时间,降低手术并发症,减少二次手术操作或后续治疗,操作简单,值得临床应用推广。

Objective： To discuss the prevention of the upper ureteral calculi from moving upwd,and the way for improving the success rate of treatment of upper ureteral calculi. Methods： 138 cases of patients with upper ureteral calculi were treated with occluder under hoimium laser or pneumatic lithotripsy ureteroscopy. Results： calculus in 132 cases were removed after one time treatment. Some calculus moved up to the kidney in 6 cases and removed after ESWL combined with drug treatment. Conclusinon： Occluder applied under holmium laser or pneumatic lithotripsy ureteroscope can reduce the upmovement of calculus in upper ureteral calculi during lithotripsy,improve the gravel and stone cleaning rate,shorten operation time,lower operative complications,and reduce the second surgical procedures or follow-up treatment. It is simple and worthy of clinical application and popularization.