经输尿管镜钬激光碎石术治疗输尿管结石150例体会

目的：探讨经输尿管镜钬激光碎石术治疗输尿管结石的疗效、安全性和影响因素。方法：采用输尿管镜钬激光碎石术治疗输尿管结石150例，其中结石并息肉36例。输尿管结石大小0.6~1.5cm，平均1.0cm。结果：150例输尿管结石患者单次碎石成功率95%,一次输尿管息肉切除成功率100%。手术时间20~60min，平均40min，术后住院时间4~8天，平均5天。8例输尿管上段结石患者，碎石过程中部分残石碎片回飘入肾盂，予以ESWL治疗。随访1~2个月，复查B超及KUB，结石均排净。无输尿管黏膜穿孔、黏膜撕脱、发热等并发症。结论：经输尿管镜钬激光碎石术治疗输尿管结石高效、安全；对结石合并息肉患者，亦可达到满意的治疗效果，是临床治疗输尿管结石最理想的治疗方法。

Experience of Treating 150 Cases of Calculus of ureter by Ureteroscope holmium laser

Objective：To evaluate the safety, efficacy, and related factors of ureteroscope holmium laser lithotripsy for ureter calculus.Methods：150 patients （36 cases with polyps） with ureter calculus and treated by holmium laser lithotr were selected for analysis. The average size of the calculus was 1.0cm （0.6-1.5cm）. Results：The single clearance rate of calculus was 95% and ureteral polyp removal rate was 100%. The average time of operation was 40 min （20-60 min）. Length of stay after operation was 5d（4-8 d）.Part of stone fragments moved up to pelvis in 8 cases whose calculus was all in the superior segment of ureter. They were then treated by ESWL. Routine assessment of stone clearance was done for all patients using USG or KUB 1-2 months after operation. No ureteral mucosal perforation, mucosal avulsion, fever and other complications were found. Conclusions：Holmium laser lithotripsy is safe and effec-tive for ureteral calculus and can also achieve satisfactory therapeutic effect for casees with polyps.