钬激光结合输尿管镜治疗泌尿系结石

目的:探讨钬激光结合输尿管镜腔内治疗泌尿系结石的安全性、有效性。方法:采用钬激光联合输尿管镜治疗泌尿系结石380例。结果:单次手术结石粉碎率达90.8%(345/380),其中肾结石成功率为81.8%(54/66),输尿管上段结石单次碎石成功率为93.1%(284/305),中、下段结石为97.9%(91/93),膀胱结石及尿道结石为100%(9/9)。结论:钬激光联合输尿管镜碎石术治疗泌尿系结石安全、有效,手术技巧容易掌握;尤其适用于结石合并输尿管狭窄、结石合并息肉形成或结石嵌顿包裹,以及体外冲击波碎石失败的患者。

The clinical effect of Holmium laser lithotripsy for urinary calculi via ureteroscope

Objective:To evaluate the therapeutic effect and safety of Holmium laser for the treatment of urinary calculi via ureteroscope.Methods:Clinical data of 380 cases of patients with urinary calculi treated with Holmium laser lithotripsy between December 2003 to September 2005 were analyzed.In this group,66 were kidney calculi,305 ureteral calculi,7 bladder calculi and 2 ureteral calculi.Among them,247 cases had hydronephrosis,56 cases with ureteral stricture,79 cases with polypus and 71 cases failed of ESWL.Results:About 90.8%(345/380) stones were fragmented in one treatment session.Complications were observed in 9.2%(35/380) of cases,mainly calculi shift and ureter perforation.Conclusions:Holmium laser lithotripsy for urinary calculi via ureteroscope is safe,effective and less invasive,especially for those complicted with ureteral stricture,polypus or failure of ESWL.