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目的:探讨双频双脉冲U-100掺钕钇铝石榴石(Nd:YAG)激光输尿管硬镜技术联合药物排石治疗输尿管结石的临床效果。方法:采用双频双脉冲U-100Nd:YAG激光碎石器及输尿管硬镜对221例输尿管结石(直径10～25mm)患者进行碎石治疗,配合术后口服坦索罗辛0.4mg/d,共28天。结果:结石碎石率分别为:上段结石76.2%,中段90.2%,下段97.9%;19例未成功,其中11例上段结石上移至肾脏,2例上段输尿管扭曲,6例输尿管狭窄置镜失败。术后1个月结石排尽率为91.4%(同期单纯ESWL为75.6%,单纯输尿管镜碎石为82.3%,P<0.05)。结论:U-100激光结合口服坦索罗辛治疗输尿管结石(直径10～25mm)安全、有效,可明显提高结石清除率。
Objective: To investigate the clinical effect of double-frequency dual-pulse U-100 neodymium-doped yttrium aluminum garnet (Nd: YAG) laser ureteral laser combined with medical stone therapy in the treatment of ureteral calculi. Methods: A total of 221 patients with ureteral calculi (diameter of 10 ~ 25mm) were treated with dual-frequency dual-pulse U-100Nd: YAG laser lithotripsy and ureteroscopic lithotripsy. Patients were treated with oral tamsulosin 0.4mg / d, A total of 28 days. Results: The rates of lithotripsy were 76.2% in the upper segment, 90.2% in the middle segment and 97.9% in the lower segment, respectively. Nineteen cases were unsuccessful, of which 11 cases had upper urethra transferred to the kidney, two cases of upper ureter distorted and six cases of ureteral stricture failed . One month after operation, the stone drainage rate was 91.4% (ESWL was 75.6% in the same period, ureteroscopic ureterolith was 82.3%, P <0.05). Conclusion: U-100 laser combined with oral tamsulosin treatment of ureteral stones (diameter 10 ~ 25mm) safe and effective, can significantly improve the stone clearance rate.