输尿管镜钬激光碎石术治疗输尿管上段结石52例报告

目的:探讨输尿管镜钬激光碎石术治疗输尿管上段结石的临床效果.方法:采用输尿管镜下钬激光碎石术治疗输尿管上段结石患者52例,其中双侧输尿管上段结石2例,共计左侧30例侧,右侧24例侧.结石大小(0.4～1.7)cm×(0.6～2.0)cm.结果:手术成功率98.1%,平均手术时间约28 min(17～65 min).1例侧因输尿管口狭窄进镜困难改行开放手术.术后1个月复查,一次性碎石排净率为90.6%,5例侧有结石残留患者保留双J管行ESWL治疗,结石排出.术后3个月复查,所有患者患侧肾积水均明显减轻.结论:在熟练掌握输尿管镜操作技术的前提下,采用输尿管镜钬激光治疗输尿管上段结石是一种安全、有效的方法.

Treating Upper Ureteral Calculi by Ureteroscope with Holmium Laser Lithotripsy (Report of 52 Cases)

Objective:To evaluate the clinical effect of ureteroscopic holmium laser Iithotripsy for treatment of upper ureteral calculi. Methods:The clinic data of 52 cases of upper ureteral calculi treated by ureteroscope with holmium laser lithotripsy were retrospectively analyzed. There are 2 cases of bilateral upper ureteral calculi, and the total number of left upper ureteral calculi was 30, and the right side of 24. The size of the stones were (0.4～1.7) cruX (0.6～2.0) cm. Resuits:The overall successful operation rate for all upper ureteral calculi stones in single procedure was 98.1% (53/54), except 1 due to ureteral stenosis converted to open surgery. The average operation time was about 28 min(17～65 min). Fellowed up after one month, one-time stone-free rate was 90.6%(48/53), 5 eases of patients with residual calculi re-tained double-J tube and performed extracorporeal lithotripsy. Fellowed up after three months, ipsilateral hydronephrosis in all patients was significantly alleviated. Conclusions: Treatment of upper ureteral calculi by ureteroscopie holmium laser lithotripsy is safe and effective, which could be preferred used as endoscopic treatment of upper ureteral calculi.