腔内钬激光碎石术治疗泌尿系复杂性结石

目的 探讨用钬激光碎石机治疗泌尿系复杂性结石。方法对肾鹿角形结石，采用开放手术加钬激光治疗；对肾外型肾盂结石和输尿管嵌顿性结石，用钬激光切除息肉后，根据结石大小采用直接粉碎法或“虫噬”法碎石，上尿路结石术后常规留置双J管引流3～4周；对前列腺增生合并膀胱结石，采用膀胱镜检查后，留置外鞘作通道，在膀胱无压力下碎石。结果 94例一次碎石成功；4例因结石逆散入肾盂和输尿管下段严重狭窄致手术失败。结石粉碎平均时间27min。结论 钬激光碎石术是治疗泌尿系复杂性结石的一种高效、安全的方法。

Intra-cavitary treatment for urological complicated calculi with holmium laser lithotripsy

Objective To explore treating urological complicated stones with holmium laser lithotripsy. Methods Stag horn calculi were treated with open surgery and holmium laser. The extrarenal pelvis stones and ureter-stuck stones was treated by holmium laser fiest removed the polyps, then direct pulverization or nibbling methods depend on the size of the stones. A double J duct was placed for 3 4 weeks after the upper ureter lithotripsy. In the case of benign prostatic hypertrophy(BPH) complicated with bladder stones, the sheath was place as the passage after cystoscopy so the lithotripsy could be performed in bladder under no pressure.Result Ninety four cases were successful with just one time lithotripsy, but 4 cases failed because of stone fragments entering the renal pelvis and extremely narrow lower ureters. The average lithotripsy time was 27 minutes. Conclusion Holmium laser lithotripsy is a effective and safe treatment for complicated urological stones.