输尿管镜钬激光治疗输尿管狭窄合并结石  

Treatment of the ureteral stenosis combined calculi by ureteroscopic incision and lithotripsy with YAG laser under holmium

作　　者：李小滨[1] 刘跃江[1] 曾柯[1] 

机构地区：[1]自贡市第一人民医院泌尿外科,四川自贡643000

出　　处：《泸州医学院学报》2012年第5期499-501,共3页Journal of Luzhou Medical College

摘　　要：目的:探讨输尿管镜钬激光治疗输尿管狭窄合并结石的方法及疗效。方法:回顾性分析2008年6月至2012年5月输尿管狭窄合并结石30例的临床资料,其中下段狭窄16例,中段狭窄9例,上段狭窄5例,输尿管狭窄段长度为0.3～1.5 cm,输尿管结石0.5～2.0 cm。均采用经输尿管镜钬激光内切开+碎石术治疗,术中留置F7～F8双J管一根,术后8～12周拔除双J管,拔管后3～6个月进行超声、静脉肾孟造影检查。结果:手术时间20～70 min,平均42min。29例手术成功,1例因并发输尿管穿孔中转开放手术,其余无明显手术并发症。术后共随访24例,时间3～24个月,21例治愈,2例好转,1例狭窄复发,再次行腔内治疗治愈。治愈率为87.5%。结论:输尿管镜钬激光内切开+碎石术治疗输尿管狭窄合并结石是一种疗效确切、安全、微创的理想手术方法,值得临床推广应用。Objective：To discuss the techniques and efficacy of the ureteral stenosis combined calculi treated by ureteroscopic incision and lithotripsy with YAG laser under holmium. Methods：Clinical data of 30 patients with ureteral stenosis combined calculi from June 2008 to May 2012,were analyzed retrospectively.Among the cases,16 at the lower ureter,9 at the middle ureter,and 5 at the upper ureter.The length of the ureteral stenosis ranged from 0.3 to 1.Scm. The size of the ureteral calculi ranged from 0.5 to 2.0 cm. Ureteroscopic incision and lithotripsy with YAG laser under holmium and setting F7 to F8 double J tube were performed on 30 ureteral stenosis combined calculi patients,and the double J tubes were pulled out after eight or twelve weeks postoperatively.Ultrasonography and excretion urography were performed 3 to 6 months after extubation. Results： The operation time ranged from 20 to 70 min with a mean of 42 min.Twenty-nine of 30 cases were successful by operations,and one of them was converted to an open surgery because of ureteral perforation.No other severe complications occurred during and after the whole procedure.Twenty-four patients out of 30 had been followed-up for 3 to 24 monthes after operation,21 cases were cured,2 improved,only one patient had recurrent stenosis,and then was cured by a second ureteroscopic intervention.And the cure rate was 87.5%. Conclusion ：Ureteroscopic incision and lithotripsy with YAG laser under holmium is an effective,safe, minimally invasive and perfect method for ureteral stenosis combined calculi.It is worth for clinical application.

关 键 词：输尿管镜 钬激光 输尿管狭窄 输尿管结石 

分 类 号：R693.4[医药卫生—泌尿科学]