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目的:通过分析输尿管硬镜钬激光输尿管结石的治疗效果,评价其临床应用价值。方法:应用WolfF8/9.8输尿管硬镜,德国Wavelight Auriga钬激光治疗仪,365～600μm光纤,激光能量500～1 200mJ,频率5～12Hz治疗406例输尿管结石患者,随防1～30个月,分析总结治疗效果。结果:除9例输尿管镜检查时结石回流入肾内,无法碎石,10例因输尿管结石远端狭窄,输尿管镜未能到达结石部位改其它方法治疗,余病人均一次成功。手术时间8～63min,平均21min。术后合并症有血尿304例,多3天内消失,最长1例血尿13天;尿痛316例,1～6天消失;发热18例,多3天后正常。术后放置双J管14～150天,平均30天。4例肾内结石行体外冲击波碎石(ESWL)。结石排净率上段89.29%(100/112),中段95.10%(136/143),下段98.68%(149/151)。结论:输尿管硬镜钬激光治疗输尿管结石创伤小,效果好,采用高频率低能量可降低上段输尿管结石返流肾内的的发生率。
Objective: To evaluate the clinical value of ureteroscopic ureteroscopic holmium laser ureteral calculi. Methods: 406 cases of ureteral calculi were treated with WolfF8 / 9.8 ureteroscope, Wavelight Auriga holmium laser in Germany, 365 ~ 600μm optical fiber, laser energy 500 ~ 1200mJ, frequency 5 ~ 12Hz, Sum up the treatment effect. Results: Except 9 cases of ureteroscopy, the stones returned to the kidney and could not be crushed. Ten cases had distal stenosis due to ureteral calculi. Ureteroscopy failed to reach the stones and treated with other methods, and the remaining patients were successfully treated. Surgery time 8 ~ 63min, an average of 21min. Postoperative complications of hematuria 304 cases, disappear more than 3 days, up to 1 case of hematuria for 13 days; dysuria 316 cases, disappeared 1 to 6 days; 18 cases of fever, more than 3 days after the normal. Postoperative double J tube 14 to 150 days, an average of 30 days. 4 cases of renal stones with extracorporeal shock wave lithotripsy (ESWL). The rate of stone removal was 89.29% (100/112) in the upper section, 95.10% (136/143) in the middle section and 98.68% (149/151) in the lower section. Conclusion: Holmium laser ureteroscopic treatment of ureteral stones trauma, the effect is good, the use of high-frequency low-energy ureteral stones can reduce the incidence of renal reflux.