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目的探讨钬激光治疗输尿管结石合并输尿管息肉或输尿管狭窄的有效性和安全性。方法应用100W钬激光碎石机通过输尿管镜对36例结石合并息肉或狭窄患者进行治疗。结果 2例合并息肉的输尿管结石先用钬激光切除息肉,然后碎石,均获成功。4例合并狭窄的输尿管结石先用钬激光切开狭窄段输尿管然后进行碎石。其中,3例获成功,1例发生穿孔,碎石成功,但有尿外渗,行尿外渗引流术,术后平均14d排尽结石。结论钬激光可以对输尿管结石合并的息肉或狭窄同时进行处理,碎石时间短,损伤小,术后并发症少;对输尿管狭窄段较长的结石患者应慎重。
Objective To investigate the efficacy and safety of holmium laser in the treatment of ureteral calculi combined with ureteral polyps or ureteral strictures. Methods Thirty-six cases of stones with polyp or stenosis were treated by ureteroscope with 100W holmium laser lithotripsy. Results 2 cases of ureteral stones with polyps first with holmium laser resection of polyps, and then gravel, were successful. In 4 patients with narrow ureteral calculi, the narrow ureter was cut with holmium laser and then gravel. Among them, 3 cases were successful, 1 case of perforation, gravel success, but the urine extravasation, urinary drainage and drainage, after an average of 14d exhaust stones. Conclusions Holmium laser can simultaneously treat polyp or stenosis of ureteral calculi with short lithotripsy, less damage and less postoperative complications. Patients with longer ureteral stricture should be cautious.