摘要
目的探讨输尿管硬镜钬激光碎石术治疗输尿管结石的有效性和安全性.方法应用钬激光碎石机、输尿管硬镜治疗输尿管结石61例.输尿管上段结石26例,输尿管中段结石4例,输尿管下段结石25例,单侧上、下段多发结石3例,异侧上、下段多发结石1例,单侧上段和下段多发结石各1例.其中重复肾双输尿管畸形伴结石2例,输尿管结石合并息肉17例.结石大小0.6cm×0.5cm～2.0cm×1.0cm,平均1.1cm×0.8cm.结果53例一次手术结石碎石成功率86.9%.其中下段结石90.0%(27/30),中段结石100.0%(4/4),上段结石83.9%(26/31).手术时间15～75min,平均24min.术后住院时间3～5d,平均4.5d.所有手术无1例发生输尿管损伤,如输尿管穿孔、断裂、粘膜撕脱,无术后感染等并发症.结论输尿管硬镜钬激光碎石术具有高效、安全、微创、并发症少等优点,是输尿管结石治疗的首选方法.但输尿管开口狭窄、结石下方输尿管扭曲、结石漂移是影响手术结果的重要因素.
ureteral calculi. Objective To evaluate the efficacy and safety Method We reviewed the data of 61 patients. of Holmium laser lithotripsy in the treatment of who underwent ureteroseopic lithotripsy using Ho：YAG laser. Among these patients, 26 cases had stones in the upper, 4 in the middle, and 25 in the lower ureter. 3 cases with stone on the mulity-places of one sides, 1 cases with stone on the mulity-places of two sides, 1 cases with multiple stones in the upper and 1 cases with multiple stones in the lower ureter. In which 2 cases had calculi with double ureteral lopsided, 17 cases had calculi with ureteral polypous. The stones was 0.6× 0.5 cm to 2.0 cm × 1.0 cm, average 1.1 cm × 0.8 cm. Results The direct success rates after the first operation which meant stone-free ureters in the lower, middle and upper ureters were 90.0% （27/30） , 100.0% （4/4） and 83.9% （26/31）. respectively, The average operating time and hospitalization time were 24min （15 ～75 min） and 4.5 d （3 -5 d）. No major complications such as perforation ureter fracture and ureter infection were encountered. Conclusions YAG laser lithotripsy is efective, mini-invasive and safe. It is indicated as the first choice in the treatment of ureteral calculi. Ureter straitness, contortion and stone transferring are of important factors influencing operation outcome.
出处
《昆明医学院学报》
2009年第6期132-134,共3页
Journal of Kunming Medical College
