输尿管软镜钬激光碎石术治疗复杂性输尿管上段结石  

Treatment of Complicated Upper Ureteral Calculi With Holmium Laser Lithotripsy Combined With Flexible Ureteroscope

作　　者：刘东亮 朱蜀侠 袁丹 王宇 胥艳 

机构地区：[1]三六三医院泌尿外科,成都610041

出　　处：《中国卫生标准管理》2015年第5期84-86,共3页China Health Standard Management

基　　金：四川省卫生厅2013年科研课题;项目编号:130564

摘　　要：目的：评价输尿管软镜钬激光治疗复杂性输尿管上段结石的有效性及安全性。方法回顾性分析2007年3月～2014年8月经输尿管软镜钬激光碎石治疗复杂性输尿管上段结石46例临床病例。所有病例均存在患侧轻—中度肾盂积水，33例合并有息肉或肉芽组织包裹，存在结石远端输尿管扭曲或狭窄13例，体外冲击波碎石术（Extracorporeal Shock Wave Lithotripsy，ESWL）治疗无效7例。结果所有病例中一次软镜手术碎石成功40例，一次手术结石粉碎率达86.9%（40／46），2例输尿管严重扭曲改为开放手术；4例软镜不能直接到达结石处，则留置双J管，1周后再次软镜碎石。结论输尿管软镜钬激光碎石术治疗复杂性输尿管上段结石有效、安全，是一种疗效确切的腔内泌尿外科碎石选择。Objective To evaluate the therapeutic effect and safety of holmium laser combined with flexible ureteroscope in the endoscopic treatment for complicated upper ureteral calculi.Methods Various clinical parameters were analyzed retrospectively in 46 patients with complicated upper ureteral calculi from March 2007 to August 2014. There were different degrees of the hydronephrosis in al the 46 cases. Among which,13 cases had urteral stricture or distortion,33 cases had polypus,and 7 cases failure of ESWL.Results 86.9%（40/46） patients obtained satisfactory lithotripsy effect with one operation. Nevertheless,2 patients changed to adopt open operation due to ureteral perforation and distortion. 4 patients underwent two-stage operation due to the failure of puting ureteroscope.Conclusion Holmium laser combined with flexible ureteroscope is a safe and effective treatment for the complicated upper ureteral calculi.

关 键 词：输尿管软镜 钬激光碎石术 复杂输尿管上段结石 

分 类 号：R693[医药卫生—泌尿科学]