输尿管镜钬激光治疗输尿管结石伴息肉28例报告

目的：总结输尿管镜钬激光治疗输尿管结石伴息肉的疗效和操作技巧。方法：回顾性分析采用钬激光经输尿管镜治疗28例输尿管结石伴息肉患者的临床资料。结果：28例患者一次碎石成功率为85．7％（24／28），一次输尿管息肉切除成功率为100％。平均手术时间50min，术后平均住院4．5天。在碎石过程中，4例输尿管上段结石部分碎片冲入肾盂，予以留置双J管，再次行ESWL。24例患者术后拔除双J导管后随访3～6个月，KUB示残余碎石均已排净，B超检查示肾积水均有不同程度缓解，其中20例患者肾积水消失，2例患者术后6个月息肉伴结石再次复发，由于拒绝开放手术，再次行输尿管镜钬激光治疗，目前仍在密切随访中。结论：对于输尿管结石伴息肉患者，采用输尿管镜下钬激光切除息肉和碎石，可以达到满意的治疗效果。

Ureteroscopic Holmium Laser Lithotripsy for the Treatment of Ureteral Calculi Complicated with Polyps (Report of 28 Cases)

Objective：To evaluate the therapeutic effect and technical of holmium laser lithotripsy on the ureteroscopic treatment of ureteral calculi with polypus. Methods： Investigated the clinical material on ureteroscopic holmium laser lithotripsy treatment of 28 cases with ureteral calculi with polypus. Results： The successful rate of laser lithotripsy is 85.7% （24/28）, and ureteral polyp resection is100% （28/28） . The mean operation time is 50min and the mean hospital stay is 4.5 days. Part of the calculi were flushed into the renal pelvis during the operation in 4 cases and a double J stent was placed in all, followed by ESWL later. The ureteral calculi exhanstion in the other 24 cases were proved by KUB in follow up 3--6 months after stent removement. The t3 ultrasonic examination showed hydronephrosis was released by different extent in all patients, including 20 cases whose hydrone- phrosis had disappeared. The ureteral stone accompanied with ureteral polyps occurred again in 2 patients in 6 months after the operations. The ureteroscopy and laser lithotripsy was performed again because the open operation was refused by the 2 patients. They are still in our intensive follow--up. Conclusions： Ureteroscopic holmium laser lithotripsy treat ureteral calculi with polypus can reach the satisfied effect.