输尿管软镜在治疗输尿管上段漂移结石中的应用

目的 探讨输尿管软镜下钬激光碎石治疗输尿管上段漂移结石的疗效和安全性.方法 2004年11月～2012年11月,在输尿管硬镜钬激光治疗输尿管上段结石中有63例结石或＞5 mm残余结石漂入肾盂,在输尿管扩张鞘或Flexor输尿管导入鞘帮助下置入输尿管软镜62例,因输尿管细沿导丝置入输尿管软镜1例,应用钬激光碎石治疗.结果 输尿管软镜下钬激光同期碎石成功率81.0％ (51/63).败血症1例,肾周包膜下血肿1例,无大出血、输尿管撕脱或断裂.结论 输尿管软镜下钬激光碎石是在输尿管硬镜碎石时对漂入肾盂内结石或残余结石的安全、有效的治疗手段.

The Treatment of Upper Ureteral Drifting Calculus through Flexible Ureteroscope

Objective To discuss the therapeutic effect and safety of holmium laser lithotripsy in the treatment of upper ureter drifting calculus through flexible ureteroscope.Methods From November 2004 to November 2012,during the procedures of holmium laser ureterolithotripsy through rigid ureteroscope,the upper ureter stones or residue fragments（5 mm） of 63 cases drifted into renal pelvis.62 cases were inserted flexible ureteroscope using ureter dilation working sheath or Flexor ureter sheath,one case was inserted flexible ureteroscope directly because of thin ureter.All the 63 cases underwent holmium laser lithotripsy.Results In the 63 cases of upper ureter stones drifting into renal pelvis,the success rate of holmium laser lithotripsy through flexible ureteroscope was 81.0%（51/63）.Complication included 1 case of sepsis and 1 case of peri-renal capsular hematoma.No serious complications such as massive blood loss,evulsion or rupture of ureter occurred.Conclusion Holmium laser treatment through flexible ureteroscope is safe and effective in treating upper ureteral calculus which drifts into renal pelvis.