输尿管镜用于中下段输尿管结石治疗的临床分析

目的探讨输尿管半硬镜联合钬激光碎石、套石蓝取石在输尿管中下段结石治疗中的安全、有效性。方法回顾分析2004～2011年间800例输尿管中下段结石患者的临床资料并比较各类输尿管镜联合不同碎石、取石技术的治疗效果,其中气压弹道碎石340例,钬激光碎石460例。结果输尿管半硬镜下钬激光碎石联合套石蓝取石术放镜成功率100%、平均手术时间（34.2±10.3）min、结石移位率1.3%、管壁损伤率1.1%、中转开放术率0.4%、术后残石率0.9%,主要技术指标均优于传统输尿管镜气压弹道碎石术。结论输尿管半硬镜联合钬激光碎石、套石蓝取石技术治疗输尿管中下段结石便捷、安全、高效,值得临床推广。

A clinical study of ureteroscopy to treat calculi in the middle and lower ureter

Objective To explore the safety and efficacy of treating calculi in the middle and lower ureter with semi-rigid ureteroscope combined with holmium laser lithotripsy and sets of reticular basket.Methods Data of 800 patients with middle and lower ureteral stones treated during 2004 to 2011 were retrospectively analyzed.340 patients received pneumatic lithotripsy and 460 holmium laser lithotripsy.Results Semi-rigid ureteroscope combined with holmium laser lithotripsy and sets of reticular basket could achieve a success rate of 100%.The mean operation time was 44 min,the stone replacement rate 1.3%,and wall injury rate 1.1%,0.4% cases changed to open surgery.The residual stone rate was 0.9%.The main technical indicators were better than those of the traditional ureteroscopic pneumatic lithotripsy.Conclusions Semi-rigid ureteroscope combined with holmium laser lithotripsy and sets of reticular basket in the treatment of middle and lower ureteral stones is convenient,safe and effective,and it is worthy of clinical application.