电子输尿管软镜联合U100Plus激光治疗上尿路2～3 cm结石的疗效研究

目的探讨电子输尿管软镜联合U100Plus激光治疗上尿路2～3 cm结石的安全性及有效性。 方法回顾性分析广州中医药大学金沙洲医院及广州医科大学附属第五医院2018年2月至2018年6月应用电子输尿管软镜结合U100Plus腔内激光碎石系统治疗66例上尿路2～3 cm结石的临床资料，记录术后1个月结石清除率，观察手术效果及围手术期并发症（Clavin-Dindo分级）情况。 结果平均结石直径（2.3±0.3）cm，单次碎石成功率100%。平均碎石时间（56±24） min，平均术后住院时间（2.3±1.2）d。术后1个月结石清除率为87.9%。手术并发症发生率为9.09%（6例），其中Ⅰ级4例，3例术后体温>38.5℃，1例反复疼痛需镇痛；ⅢA级2例，术后1个月形成输尿管石街，再次手术清石。 结论电子输尿管软镜联合U100Plus激光治疗上尿路2～3 cm结石，碎石效率高，并发症少，结石清除率高。

Digital flexible ureteroscope combined with U100Plus laser in the treatment of 2-3 cm upper urinary calculi

ObjectiveTo evaluate the efficacy and safety of digital flexible ureteroscope combined with U100Plus laser in the treatment of 2-3 cm upper urinary calculi. MethodsThe clinical data of 66 patients with 2-3 cm upper urinary tract calculi treated by digital flexible ureteroscope combined with U100Plus laser lithotripsy from February to June 2018 in Jinshazhou Hospital of Guangzhou University of Chinese Medicine and the Fifth Hospital of Guangzhou Medical University were retrospectively analyzed. The stone free rate in one month after operation was calculated, and the outcome of operation were observed, as well as complications (Clavin-Dindo classification). ResultsThe mean diameter of stones were (2.3±0.3) cm, and the success lithotripsy rate of single-stage was 100%. The average time of lithotripsy was (56±24) min, and postoperative hospital stay was (2.3±1.2) days. The stone free rate (SFR) was 87.9% after one month. The incidence of surgical complications was 9.09% (6 cases), including Grade I in 4 cases, 3 cases had fever (>38.5℃), and one required analgesia for recurrent pain. 2 cases had ureteral steinstrasse (Grade IIIA) were performed ureteroscopic procedure to remove the stone. ConclusionDigital flexible ureteroscope combined with U100Plus laser in the treatment of 2-3 cm upper urinary calculi has high lithotripsy efficiency, fewer complications and high stone clearance rate.