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目的探讨钬激光联合输尿管镜技术治疗输尿管结石的临床效果。方法2004年4-11月采用美国科医人公司LUMENIS POWER Suite 100 W钬激光及Circom MRO输尿管镜对72例输尿管结石进行碎石治疗。经尿道输尿管镜直视下到达结石部位,采用钬激光腔内碎石治疗。结果手术时间14-83 min,平均28 min。3例失败由于位于输尿管上段的结石移至肾脏,一次碎石成功率95.8%(69/72),其中上段结石成功率92.1%(35/38)、中下段结石成功率100%(34/34)。术中输尿管穿孔3例(4.2%)、结石移动9例(12.5%)、血尿72例(100%);术后腰痛45例(62.5%)、血尿72例(100%)、泌尿系感染5例(6.9%),无输尿管狭窄发生。术后第1天KUB检查无结石率86.1%(62/72),余7例均于2周内排净。术后住院2-5 d,平均3 d。49例术后3个月复查B超或静脉尿路造影,均未发现输尿管狭窄,28例肾积水减轻(1.4±0.5)cm、21例肾积水消失。结论钬激光联合输尿管镜技术治疗输尿管结石临床疗效好、并发症少。
Objective To investigate the clinical effect of holmium laser combined with ureteroscopy in the treatment of ureteral calculi. Methods From April to November 2004, 72 patients with ureteral calculi underwent lithotripsy with LUMENIS POWER Suite 100 W holmium laser and Circom MRO ureteroscope. Transurethral ureteroscopy to reach the stones under direct vision, holmium laser lithotripsy treatment. Results The operation time was 14-83 min with an average of 28 min. 3 cases of failure due to the upper ureteral calculi moved to the kidney, a gravel success rate was 95.8% (69/72), of which the success rate of upper stones 92.1% (35/38), lower stones success rate of 100% (34/34 ). There were 3 cases (4.2%) of ureter perforation, 9 cases of calculi movement (12.5%) and 72 cases of hematuria (100%). Postoperative low back pain occurred in 45 cases (62.5%), hematuria in 72 cases Cases (6.9%), no ureteral stricture occurred. On the first day after operation, the KUB examination showed no stones in 86.1% (62/72) and the remaining 7 cases were discharged within 2 weeks. Postoperative hospitalization 2-5 d, an average of 3 d. 49 cases were examined by B-mode ultrasonography or intravenous urography three months after operation. No ureteral stricture, hydronephrosis in 28 cases (1.4 ± 0.5) cm and disappearance of hydronephrosis in 21 cases. Conclusion Holmium laser combined with ureteroscopy in the treatment of ureteral calculi clinical efficacy, fewer complications.