输尿管镜钬激光碎石治疗嵌顿输尿管结石70例临床分析

目的:探讨输尿管镜钬激光治疗嵌顿性输尿管结石的有效性和安全性。方法:分析2007年5月～2010年5月输尿管镜下钬激光碎石治疗嵌顿输尿管结石70例临床资料,对碎石率、排石率和并发症等进行统计分析。结果:共行72例次输尿管镜钬激光碎石,一次碎石成功率91.7%(66/72),输尿管上段与中、下段结石一次碎石成功率分别为71.4%(10/14)和96.6%(56/58)。1月后复查结石排净率90.3%(65/72),肾盂积水由(2.5±0.4)cm降至(1.3±0.3)cm(P<0.01);随访3～30个月,1例发现输尿管狭窄。结论:输尿管镜钬激光碎石治疗嵌顿输尿管结石安全、有效,尤其适用于中、下段嵌顿输尿管结石。

Holmium Laser Lithotripsy for Ureteral Calculi Incarcerated

Objective:To evaluate the efficacy and safety of ureteroscope lithotripsy with Holmium laser for treatment of ureteral stone with granulation.Methods:From May 2007 to May 2010,a total of 70 patients of ureteral stones with granulation underwent ureteroscope lithotripsy using Holmium laser,the clinical data were retrospectively analysed.Results:The overall rate of successful fragmentation for all levels of ureteral stones in a single procedure achieved 91.7%(66/72).The success rates of fragmentation for the upper and mid—lower levels of ureteral stones was 71.4%(10/14) and 96.6%(56/58).After one month,the stone-free-rate was 90.3%(65/72) and the hydronephrosis was markedly decreased from preoperative(2.5±0.4)cm to postoperative(1.3±0.3)cm according to B ultrasound or IVU(P<0.01).1 case occurred ureteral stenosis after follow-up from 3 to 30 months.Conclusion:Ureteroscopy and Holmium laser lithotripsy is a highly effective,minimally invasive and safe therapy for treatment of ureteral stone with granulation,especially for those with middle or lower levels of ureteral stone with granulation.