输尿管镜下钬激光碎石术治疗上尿路结石梗阻并发急性肾功能衰竭(附25例报告)

目的总结输尿管镜下钬激光碎石术治疗上尿路结石梗阻并急性肾功能衰竭的效果。方法2004年12月-2007年11月25例上尿路结石梗阻并急性肾功能衰竭患者，均在输尿管镜直视下行钬激光碎石术治疗。结果手术均获成功，术中无一例患者出现输尿管穿孔、断裂、粘膜撕脱，无中转开放手术。术后随访1-3个月，22例患者血尿素氮、肌酐恢复正常，3例接近正常，结石排净率92%（23/25）。结论输尿管镜下钬激光碎石术治疗上尿路结石梗阻并急性肾功能衰竭，微创、安全、疗效肯定、可同时处理双侧输尿管病变，可作为首选治疗方法，但应严格掌握适应证。

Transureteroscopic Holmium:YAG Laser Lithotripsy for Upper Urinary Calculi Obstruction Associated with Acute Renal Failure(A Report of 25 Cases)

Objective To assess the effect of transureteroscopic Holmium：YAG laser lithotripsy for upper urinary calculi obstruction associated with acute renal failure.Method Twenty-five cases of upper urinary calculi obstruction associated with acute renal failure admitted from December 2004 to November 2007 were underwent Holmium：YAG Laser lithotripsy under ureteroscope.Results No severe complication such as ureteral perforation,fracture and mucosal avulsion occurred during the operation.And no one was converted to open operation.Within 1 to 3 months follow-up,the serum BUN and Cr level was decreased to normal in 22 cases and nearly normal in 3 cases,and the stone-free rates was 92.0%.Conclusions Transureteroscopic Holmium：YAG laser lithotripsy can deal with bilateral ureteral diseases simultaneously,and can be recommended as a primary procedure for upper urinary calculi obstruction associated with acute renal failure with advantages as mini trauma and reliable effect,nevertheless the indications must be selected strictly.