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目的探讨输尿管镜下钬激光碎石术治疗输尿管上段结石的疗效。方法回顾性分析2006年3月~2014年3月应用输尿管镜下钬激光碎石术治疗输尿管上段结石共计170人185例，对较大的碎石块主动取出。结果4例结石逆行向上进入肾③，其中3例改行经皮肾镜下碎石取石术，1例术后改行体外冲击波碎石术，其余均一次碎石成功。4w后复查KUB平片均无结石残留。结论我们认为对ESWL失败或结石最长径大于1cm伴有明显肾积水的输尿管上段结石采用输尿管镜下钬激光碎石安全有效，应为首选方法，值得推广。“,”Objective To evaluate the ef ectiveness and safety of ureteroscopic holmium: YAG laser lithotripsy for managing proximal ureteral calculi. Methods Retrospective analysis of 170 patients with upper ureteral calculi treated with holmium laser lithotripsy under the March 2006 ~2014 in March, 185 cases of upper ureteral calculi were treated with the large stones. Results 4 cases of calculi retrograde to into the renal pelvis, which 3 cases diverted via percutaneous nephrolithotomy lithotripsy stone operation, 1 cases of postoperative diverted extracorporeal shock wave lithotripsy, the rest of the uniform gravel success. After 4W, the KUB was not free of stones. Conclusion The safety and ef ectiveness of ESWL failure or the maximum diameter of the stones in the upper ureteral calculi with obvious renal and water was safe and ef ective, and should be the prefer ed method, which is worth popularizing.