半硬性输尿管镜下钬激光碎石治疗输尿管结石的临床分析

目的:探讨对输尿管结石患者应用半硬性输尿管镜下钬激光碎石治疗的临床效果。方法:观察组673例患者腰麻下均应用美国顺康(Circon)生产的8.0/9.2F半硬性输尿管镜进行碎石治疗。对照组1采用体外震波碎石(ESWL)治疗;对照组2行输尿管切开取石术治疗。结果:观察组患者的碎石成功率明显高于对照组(P<0.05)。其中13例患者因远端输尿管狭窄段太长致置镜失败,11例患者输尿管有扭曲导致镜下无法看清结石,3例患者发生输尿管穿孔,均中转为开放性手术治疗。结论:半硬性输尿管镜下钬激光碎石治疗输尿管结石单次碎石成功率高,术中对输尿管等粘膜损伤较小,值得临床应用。

Semi-rigid ureteroscopic holmium laser lithotripsy for the treatment of ureteral calculi

Objective: To explore the clinical effects of semi-rigid ureteroscopic holmium laser lithotripsy for the treatment of ureteral calculi.Methods: A total of 673 cases of ureteral calculi were treated with semi-rigid ureteroscopic holmium laser lithotripsy(Circon,USA) during May 2005 to May 2011(Observation group).Extracorporeal shock wave lithotripsy(ESWL) was applied in 192 cases of the control group 1,and ureterolithotomy line treatment in 162 cases of control group 2.Results: The observation group showed significantly higher success rate of gravel than the two control groups(P <0.05),but 27 cases underwent open surgery because of ureteral stricture in 13 cases,distortion in 11 cases and ureteral perforation in 3 cases.Conclusions: Semi-rigid ureteroscopic holmium laser lithotripsy for the treatment of ureteral calculi shows high clearance rate,minimal injury,and is worthy of clinical appllication.