侧卧位输尿管软镜下钬激光碎石术治疗上尿路结石35例

目的探讨侧卧位输尿管软镜下钬激光碎石术治疗上尿路结石的疗效。方法对35例上尿路结石采用自行设计的侧卧位,输尿管硬镜镜体扩张后留置输尿管扩张鞘,再置入输尿管软镜,寻及结石以钬激光击碎结石。结果侧卧位输尿管软镜下钬激光碎石治疗上尿路结石35例,单次碎石成功率97.1%（34/35）,手术时间平均35 m in（20-50 m in）,住院时间平均5 d（3-7 d）,无脓肾、输尿管穿孔等并发症。结论侧卧位输尿管软镜下钬激光碎石术治疗上尿路结石安全、有效、并发症少,尤其适用于结石体积较小,肾盂肾盏无明显积水,以及因解剖特点预期ESWL效果欠佳的患者。女性患者成功率更高。

Lateral decubitus deflectable ureteroscopy and holmium laser lithotrity for upper urinary calculi

Objective To assess the efficacy of lateral decubitus deflectable ureteroscopy and holmium laser lithotrity in the treatment of upper urinary calculi. Methods 35 cases of upper urinary calculi were treated with a special lateral decubitus designed by ourselves. Ureteric dilatation was performed by a rigid urcteroscope before a sheathing canal was put into the ureter. A deflectable ureteroscope followed the canal for holmium laser lithotrity. Results Of the 35 cases,97.1% （ 34/35 ） were successful with single stage operation. The mean operation time was 35min （20 - 50min ）. The mean hospitalizing time was 5 days（3 -7days）. No pyonephrosis or ureteral perforation occurred. Conclusion Lateral decubitus deflectable ureteroscopy and holmium laser lithotrity for upper urinary calculi are safe and effective with few complications. It should be recommended espicially for those with no notable hydronephrosis or with bad prognosis by ESWL for anatomic reasons. The method works better for female patients.