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目的:探讨组合式输尿管软镜钬激光碎石术治疗上尿路结石的疗效和安全性。方法:回顾性分析2013年1月~2013年10月诊治的45例采用组合式输尿管软镜钬激光碎石术治疗上尿路结石患者的临床资料,对其手术并发症和结石取净率等资料进行分析。结果:45例患者均顺利完成手术。手术时间35~130min,平均52min。无大出血、输尿管撕脱、输尿管穿孔等并发症发生,术后3例出现发热。Ⅰ期结石取净率为88.9%(40/45),5例残石患者中,1例残石位于肾中盏、4例残石位于肾下盏,残石大小0.6~0.8cm。结论:组合式输尿管软镜钬激光碎石术治疗上尿路结石具有接近“无创”、安全、有效、可重复治疗等优点,值得临床推广应用。
Objective: To investigate the efficacy and safety of combined ureteroscopic holmium laser lithotripsy in the treatment of upper urinary tract calculi. Methods: The clinical data of 45 patients who underwent combined ureteroscopic holmium laser lithotripsy in the treatment of upper urinary tract calculi from January 2013 to October 2013 were retrospectively analyzed. The complications such as surgical complications and rate of stone removal Data analysis. Results: All the 45 patients completed the operation smoothly. Surgery time 35 ~ 130min, an average of 52min. No major bleeding, ureteral avulsion, ureteral perforation and other complications occurred in 3 cases of fever. The rate of stone removal in stage Ⅰ was 88.9% (40/45). Among the 5 patients with residual stone, one was found in the middle of the kidney and the other 4 in the lower kidney. The residual stone size was 0.6-0.8 cm. Conclusion: Combined ureteroscopic holmium laser lithotripsy for the treatment of upper urinary calculi has the advantages of close to “noninvasive”, safe, effective and repeatable treatment. It is worthy of clinical application.