输尿管软镜下钬激光碎石治疗体外震波碎石失败后复杂性输尿管结石的临床探讨  

Clinical Observation on Holmium Laser Lithotripsy Under Flexible Ureteroscope for Complexity Ureteral Calculi After Failed Extracorporeal Shock-wave Lithotripsy

作　　者：姚亚雄[1,2] 卢建路[1,2] 冀强[1,2] 汪永清[1,2] 柳林[1,2] 

机构地区：[1]河南理工大学第一附属医院 [2]焦作市第二人民医院泌尿外科,河南焦作454000

出　　处：《中外医疗》2015年第16期69-70,共2页China & Foreign Medical Treatment

摘　　要：目的探讨输尿管软镜下钬激光碎石治疗体外震波碎石失败后复杂性输尿管结石的临床效果。方法选取2014年2月—2014年12月期间该院收治的复杂性输尿管结石患者80例,其中40例体外震波碎石失败后使用微创经皮肾穿刺取石+术(MPCNL)的患者作为对照组,另外40例体外震波碎石失败后使用输尿管软镜下钬激光碎石治疗的患者作为研究组,分析研究两组的治疗效果。结果对照组患者碎石成功率为95.0%(38/40),研究组患者中碎石成功率为92.50%(37/40),上段结石成功率80.00%(8/10),中段结石成功率90.00%(9/10),下段结石成功率95.00%(19/20),失败3例,占7.50%(3/40),研究组与对照组碎石成功率之间差异无统计学意义(P>0.05)。其中有2例冲入肾盂后再次经输尿管软镜下钬激光碎石治疗,1例通过后腹腔镜下输尿管结石切开取石的方式取石,手术中输尿管穿孔1例,手术平均时间(65±15.50)rnin,住院时间(7.50±1.50)d。结论输尿管软镜下钬激光碎石是一种治疗体外震波碎石失败后复杂性输尿管结石的可靠手段,临床应用前景广阔。Objective To evaluate the efficacy of the hohnium laser lithotripsy under Flexible ureteroscope for the complexity ureteral calculi after failed extracorporeal shock-wave lithotripsy（ESWL）.Methods 80 complexity ureteral calculi patients were divided into control group and study group during February 2014 to December 2014,40 patients after failed ESWL treated with MPCNL as control group and 40 after failed ESWL treated with holmium laser lithotripsy under ureteroscope as study group.Compared the successful rates and failure rates.Results The success rate in the control group was 95.0%（38/40） and in the study group the overall stone-free rate was 92.50%（37/40）,and the successful rate was 80.00%（8/10）in the upper segment,90.00%（9/10）in the middle segment,95.00%（19/20）in the lower segment,7.50%（3/40） failed.The differences of the success rate between the study group and the control group was not statistically significant（P〉0.05）.2 of them were failed due to the stones returning to the kidney and treated with ESWL again,1 of them chose for Retroperitoneoscopic lithotomy.1 case was encountered ureter perforation.The mean operative time was（65±15.50）mins and the average hospitalization time was（7.50±1.50） days.Conclusion Holmium laser lithotripsy under ureteroscope after failed ESWL for ureteral calculi was feasible and effective.

关 键 词：输尿管软镜 钬激光 输尿管结石 体外震波碎石 

分 类 号：R693.4[医药卫生—泌尿科学]