输尿管结石致顽固性肾绞痛的钬激光处理

Holmium laser lithotripsy for the treatment of refractory renal colic due to ureteric calculi

目的：探讨钬激光碎石术治疗输尿管结石致顽固性肾绞痛患者的疗效情况。方法：2014年06月至2017年06月,我们对24例因输尿管结石致顽固性肾绞痛的患者,采用钬激光进行输尿管镜下碎石术治疗,对其碎石及疼痛缓解情况进行疗效分析。结果：20例患者一次钬激光碎石手术成功,1例患者输尿管明显扭曲狭窄致输尿管镜不能通过,1例患者结石返回肾脏,仅留置双J管,2例患者输尿管内较多脓性分泌物,考虑感染,同时结石小,采用取石钳将结石取出。一次钬激光碎石处理成功率为83.3%（20/24）,术后当天肾绞痛均好转。结论：钬激光碎石术治疗输尿管结石致顽固性肾绞痛是一种安全、有效、微创的治疗措施。

Objective： to investigate the safety and efficacy of holmium laser lithotripsy for the treatment of refractory renal colic due to ureteric calculi. Methods： a retrospective analysis was made on the 24 cases of refractory renal colic caused by ureteric calculi treated with retrograde ureteroscopic holmium laser lithotripsy from June 2014 to June 2017. Results： 20 cases received holmium laser lithotripsy successfully. One case failed to use ureteroscopy due to obvious ureteral distortion and stricture. One case received intra-ureteral double-J cannula due to the stone returning to the kidney. Two cases were found that the ureter had purulent secretion caused by infection,then using stone clamp to remove the stones considering the small size. The success rate of holmium laser lithotripsy was 83. 3%（ 20/24）,and the renal colic was improved on the day of operation. Conclusion： holmium laser lithotripsy for the treatment of refractory renal colic caused by ureteral calculi is a safe,effective and minimally invasive treatment.