内镜下钬激光治疗输尿管结石(附316例报告)

Endoscopic lithotripsy in the ureteral calculi with holmium laser (report of 316 cases)

目的 探讨钬激光在内镜下治疗输尿管结石中的疗效及技术特点。方法 对 316例输尿管结石病人 (343侧结石 )使用经尿道输尿管肾镜钬激光碎石 ,合并有息肉时行息肉切除。结果 343侧结石一次性碎石成功 330侧 (96 .2 % ) ,7例结石上移进入肾盂 ;6例碎石不完全 ,未能排出 ,术后加用体外震波碎石或二次钬激光腔内碎石。碎石中出现输尿管穿孔 1例 ,感染性休克 1例。术后血尿时间 1d ,术后平均住院时间 3d。术后平均碎石块排净时间 2 2d。结论 内镜下钬激光碎石治疗输尿管结石是一种安全 ,有效 ,创伤小 ,恢复快的手术方式。

Objective:To evaluate the therapeutic effect and technique characteristic of holmium laser in endoscopic lithotripsy of ureteral calculi. Methods:Three hundred and sixteen patients with 343 ureteral calculi treated by ureterorenoscope with holmium laser lithotripter,ployp was ablated when it complicated.Results:The overall successful stone fragmentation rate of ureterat calculi was 96.2%(330/343),7 cases of stone migration,6 incomplete fragmentation. Required extracorporeal shock-wave lithotripsy(ESWL) or 2nd endoscopic lithotripsy with holmium laser.One ureteralperforation and 1 infections shock occurred when the holmium laserwas used. The mean stone-free elimination time was 22 days.The mean post-operation hospital stay was 3 days;The mean post- operation hematuria time was 1 day.Conclusions: Ureteroscopic lithotripsy using the holmium laser is a safe,efficient and minimally invasive method for the treatment of ureteral calculi.