输尿管镜钬激光碎石术并发症探讨（附242例报告）

目的：探讨输尿管镜钬激光碎石术并发症发生原因及处理措施。方法：回顾分析2007年6月-2009年12月共开展输尿管镜钬激光手术242例，出现并发症共37例，发生率15．3％。其中输尿管黏膜撕裂1倒，予留置双J管；输尿管穿孔并发腹膜炎1例，予开放手术并置管引流；置镜失败13例中11例改开放手术；术后尿路感染16例；结石上移冲入肾孟3例，1例改行经皮肾输尿管镜钬激光碎石术，1例子肾盂内钬激光碎石，另1例留置双J管，行体外震波碎石治疗；结石残留输尿管3例，1例行体外震波碎石治疗，另2例经随访拔除双J管2周后结石自行排出。结果：37例均获治愈，未发生二次并发症。结论：了解输尿管镜钬激光碎石手术并发症的原因，提高操作水平，减少并发症的发生。

The treatment and prevention of complications associated with holmium：YAG laser ureterolithotripsy

Objective：To study the cause and the resolvent of complications associated with holmiu： YAG laser ureterolithotripsy. Methods..Re- view242 ureteroscopy holmium; YAG laser surgery cases from June 2007 to December 20091 37 cases were found with complications , the rate was 15.3%. one patient suffered with Ureteral mucosa tear who retained to double J tube; one patient with Ureteral surgery was peritonitis and treated with open surgery and laid tube drainage; 11 of the 13 cases which failed with installed mirror changed to open surgery. Postoperative urinary tract infections were found in 16 patients ; Stone move up to renal pelvis were found in 3 cases which switched to percutaneous renal ureteroscopy holmi- um：YAG laser lithotripsy, the renal pelvis holmium：YAG laser lithotripsy and the lien double J tube respectively line extracorporeal shock wae lith- otripsy treatment; 3 cases with Residual ureteral stones , 1 routine extracorporeal shock wae lithotripsy treatment,the other two？ cases followed up by pulling out the double J tube,the stones pass spontaneously after 2 weeks. Result; 37 cases were cured, and did not happen secondary complications. Conclusion：The skilled operation and strict indication are important for reducing complications.