输尿管镜钬激光碎石联合封堵器治疗输尿管上段结石的疗效观察  

Curative Effect Observation on Ureteroscopic Holmium Laser Lithotripsy Combined with Occluder in Treatment of Upper Ureteral Stones

作　　者：马永琪 王忠云 周建文 潘文豪 杨艳 宦蕾 MA Yongqi;WANG Zhongyun;ZHOU Jianwen;PAN Wenhao;YANG Yan;HUAN Lei(Department of Urology,Chuxiong YI Autonomous Prefecture Traditional Chinese Medicine Hospital,Chuxiong,Yunnan 675000)

机构地区：[1]楚雄彝族自治州中医医院泌尿外科,云南楚雄675000

出　　处：《智慧健康》2024年第3期94-97,共4页Smart Healthcare

基　　金：楚雄医药高等专科学校科研基金项目《输尿管镜钬激光碎石联合封堵器治疗输尿管中上段结石的临床研究》(项目编号:2023YYXM30)。

摘　　要：目的 探讨输尿管镜钬激光联合封堵器治疗输尿管上段结石的临床疗效,为临床治疗输尿管上段结石选择微创手术方法提供参考。方法 对2021年6月—2023年6月在本院泌尿外科行输尿管镜钬激光联合封堵器治疗的106例输尿管上段结石患者的临床资料进行研究,统计患者的手术时间、结石上移率、结石清除率、术后并发症等情况。结果 94例一次性碎石成功;5例上移回肾脏,改行RIRS后取出;7例输尿管狭窄输尿管镜不能置入的患者,其中3例改PCNL、4例留置输尿管支架被动扩张后二期行输尿管镜取出结石。15例发生术后发热、明显血尿、腰腹部疼痛等并发症,对症处理后均缓解,未发生输尿管严重损伤的情况。结论 输尿管上段结石患者在输尿管镜钬激光碎石治疗中联合使用封堵器,有助于减少术中结石上移率并明显提高结石清除效果,减少二次手术的概率,在临床中值得广泛推广应用。Objective To explore clinical effect of ureteroscopic holmium laser combined with occluder in treatment of upper ureteral stones,and provide reference for selection of minimally invasive surgical methods in clinical treatment of upper ureteral stones.Methods The paper reviewed and studied clinical data of 106 patients with upper ureteral stones with ureteroscopic holmium laser and occluder treatment in urology department of our hospital from June 2021 to June 2023.Surgical time,stone migration rate,stone clearance rate,and postoperative complications of patients were statistically analyzed.Results Lithotripsy 94 cases was one-time successful,5 cases moved back to kidneys and removed after RIRS,for 7 cases not being able to insert ureteroscopy for ureteral stenosis,3 cases were treated with PCNL,4 cases with second stage ureteroscopy for stone removal after passive dilation of ureteral stent,15 cases with postoperative complications including fever,obvious hematuria and lower back and abdominal pains,were relieved after symptomatic treatment,with no severe ureteral injury.Conclusion Ureteroscopic holmium laser lithotripsy combined with occluder can reduce intraoperative stone migration rate,significantly improve stone removal effect,and reduce probability of secondary surgery of patients with upper ureteral stones,which is worthy of promotion and application widely in clinical practice.

关 键 词：输尿管镜 钬激光 封堵器 输尿管结石 

分 类 号：R699.4[医药卫生—泌尿科学]