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目的:评价输尿管镜钬激光碎石联合腔内两重双J管引流术处理ESWI治疗失败输尿管结石的临床疗效.并探讨其影响因素。方法:2005年1月～2010年6月对ESWL失败的21例输尿管结石患者行输尿管镜钬激光碎石术,碎石后置入两根双J管,术后常规留置2～4周后拔除。结石合并息肉形成的13例患者均同期采用钬激光汽化切割息肉。结果:21例输尿管结石行钬激光碎石成功率达95.2%(20/21),手术时间10～70 min,平均(40.4±10.3)min;术后住院时间1～7天.平均(3.1±1.2)天。结论:输尿管镜钬激光碎石联合腔内两重双J管引流术处理ESWL治疗失败输尿管结石是安全可行的,保证结石清除率的同时不增加并发症发生率。
OBJECTIVE: To evaluate the clinical efficacy of ureteroscopic holmium laser lithotripsy combined with double dual J-tube drainage in the treatment of failed ureteral stones treated with ESWI and its influencing factors. Methods: From January 2005 to June 2010, ureteroscopic holmium laser lithotripsy was performed in 21 patients with ureteral calculi that failed to achieve ESWL. Two double J tubes were inserted into the gravel and routinely removed for 2 to 4 weeks . Thirteen patients with stones and polyps formed during the same period were treated with holmium laser vaporization of polyps. Results: The success rate of holmium laser lithotripsy in 21 patients with ureteral calculi was 95.2% (20/21), the operation time was 10-70 min (mean, 40.4 ± 10.3) min and the postoperative hospital stay was 1 to 7 days 1.2) days. Conclusions: Ureteroscopic holmium laser lithotripsy combined with double double lumen drainage in the treatment of ureteral calculi with ESWL is safe and feasible, which can ensure the clearance rate without increasing the complication rate.