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目的评价输尿管软镜钬激光碎石治疗肾输尿管上段结石的效果,探讨操作技巧。方法 2010年9月-2014年9月行输尿管软镜钬激光碎石治疗的肾输尿管上段结石患者150例,结石直径为0.8~4.2 cm。早期患者均先置F5双J管2周,再行输尿管软镜碎石。自2014年起均采用直接一期输尿管软镜碎石,术后3~5 d及术后4周复查腹部X线片及CT,评价碎石及排石效果。结果输尿管软镜一次性进镜率98.7%(148/150);碎石成功率98.7%(148/150);结石清除率97.3%(146/150);手术时间20~126 min,平均40 min。2例术后出现尿源性败血症,经治疗缓解。结论输尿管软镜钬激光碎石手术创伤小,恢复快,并发症发生率低,结石排净率高,是治疗肾输尿管上段结石安全有效的方法。
Objective To evaluate the efficacy of ureteroscopic holmium laser lithotripsy in the treatment of upper ureteral calculi, and to explore operating skills. Methods From September 2010 to September 2014, 150 cases of upper ureteral calculi treated with ureteroscopic holmium laser lithotripsy were treated. The diameter of stones was 0.8 ~ 4.2 cm. Early patients are first placed F5 double J tube for 2 weeks, then ureteroscopic soft lithotripsy. Since 2014, direct ureteroscopic ureteroscopic lithotripsy was performed. Abdominal X-ray and CT were performed 3 to 5 days and 4 weeks after operation to evaluate the effect of gravel and row of stones. Results The ureteroscope had a one-time entrance rate of 98.7% (148/150), gravel success rate of 98.7% (148/150), stone clearance rate of 97.3% (146/150), operation time of 20-126 minutes . 2 cases of urinary septicemia after treatment, remission after treatment. Conclusions Ureteroscopic holmium laser lithotripsy is a safe and effective method for the treatment of upper ureteral calculi because of less trauma, faster recovery, lower complication rate and high rate of stone removal.