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目的探讨经输尿管肾镜联合钬激光碎石术治疗输尿管结石的有效性及安全性。方法分析2005年1月至2006年12月收治的经输尿管肾镜钬激光治疗输尿管结石206例的临床资料。其中181例伴有患侧轻至中度肾盂积水,IVP患肾不显影19例,28例同时合并结石远端输尿管狭窄,57例合并有息肉或肉芽组织包裹,26例为体外冲击波碎石术(ESWL)治疗失败。结果206例中195例单次手术碎石成功,单次手术结石粉碎率达94.7%(195/206)。平均手术时间25min,术中无输尿管穿孔等并发症发生,平均住院日5.5d。10例结石在钬激光碎石过程中移位于肾盏或结石残留,术后再行ESWL治愈;1例双侧输尿管结石,因输尿管狭窄无法入镜,中转开放手术。结论输尿管肾镜联合钬激光碎石术治疗输尿管结石有效、安全,可作为输尿管结石特别是中下段结石首选的治疗方法。
Objective To investigate the effectiveness and safety of ureteroscopic combined with holmium laser lithotripsy in the treatment of ureteral calculi. Methods The clinical data of 206 cases of ureteral calculi treated by ureteroscopic holmium laser during January 2005 to December 2006 were analyzed. Among them, 181 cases were accompanied with mild to moderate hydronephrosis, IVP had no renal development in 19 cases, 28 cases with distal ureteral stricture of calculi, 57 cases were complicated with polyp or granulation tissue, 26 cases were extracorporeal shock wave lithotripsy Surgery (ESWL) failed. Results A total of 195 cases of single operation were successfully performed in 206 cases. The rate of single operation stone crushing was 94.7% (195/206). The average operation time was 25 minutes. No complications such as ureter perforation occurred during operation. The average length of stay was 5.5 days. 10 cases of stones in the holmium laser lithotripsy shift in the calyx or stones remaining after ESWL cure; 1 case of bilateral ureteral stones, due to ureteral stricture can not enter the mirror, the transfer of open surgery. Conclusions Ureteroscopic combined with holmium laser lithotripsy for the treatment of ureteral calculi is effective and safe and can be used as the preferred treatment for ureteral calculi, especially in the middle and lower calculi.