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目的探讨输尿管镜下U100激光治疗输尿管结石的疗效、失败原因及并发症。方法回顾性分析2003年2月至2006年10月输尿管镜下用U100激光碎石技术治疗541例输尿管结石患者的临床资料。结果1次碎石成功率达91.3%(494/541),其中输尿管上段结石177例1次成功,成功率为85.1%(177/208);中下段317例1次成功,成功率为95.2%(317/333),上段与中下段成功率差异有显著性(P<0.005)。术后1周结石总排净率为86.0%(425/494),其中上段为78.0%(138/177),中下段为90.5%(287/317),术后1周上段与中下段结石排净率差异有显著性(P<0.005)。术中输尿管穿孔3例,无输尿管断裂、内膜撕脱,术后无输尿管狭窄。结论输尿管镜下U100激光碎石效率高、对组织损伤小、并发症少、结石排净率高、患者住院时间短、恢复快,是一种高效、安全的腔内碎石方法。
Objective To investigate the efficacy, failure causes and complications of ureteroscopic U100 laser treatment of ureteral calculi. Methods The clinical data of 541 patients with ureteral calculi underwent ureteroscopy with U100 laser lithotripsy from February 2003 to October 2006 were analyzed retrospectively. Results The success rate of primary lithotripsy was 91.3% (494/541). Among them, 177 cases of upper ureteral calculi were successful in 1 case with a success rate of 85.1% (177/208); 317 cases of middle and lower segment were successful in 1 case with a success rate of 95.2% (317/333). There was significant difference between the success rate of upper and lower middle segment (P <0.005). The total rate of stone removal was 86.0% (425/494) at 1 week after operation, with the upper segment being 78.0% (138/177) and the middle segment being 90.5% (287/317). The upper segment and middle segment The net rate difference was significant (P <0.005). Intraoperative ureter perforation in 3 cases, no ureter rupture, endometrial avulsion, no ureteral stricture. Conclusions The ureteroscopic U100 laser lithotripsy is a highly efficient and safe method for intracavitary lithotripsy with high efficiency, less tissue damage, fewer complications, high rate of stone removal, shorter hospital stay and faster recovery.