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目的探讨输尿管镜钬激光碎石术治疗嵌顿性输尿管结石的疗效及安全性。方法回顾性分析2007年8月～2009年6月收治的经输尿管镜钬激光治疗嵌顿性输尿管结石56例的临床资料。56例均伴有患侧肾盂积水,其中9例合并结石远端输尿管狭窄,31例合并有息肉或肉芽组织包裹,16例为体外冲击波碎石治疗失败后。结果中、下段结石42例均1次完全粉碎,术后2周复查,碎石排净率100%。上段结石14例,12例1次粉碎,术后2周复查,碎石排净率86%,2例部分结石碎片上移至肾盂,保留双J管经1次体外冲击波碎石后,结石排净。56例随访3～10个月,肾积水均明显减轻。结论输尿管镜钬激光碎石术治疗嵌顿性输尿管结石疗效确切,安全性高,侵袭性小,是处理输尿管嵌顿结石,尤其是中、下段输尿管嵌顿结石的一种有效微创手段。
Objective To investigate the efficacy and safety of ureteroscopic holmium laser lithotripsy in the treatment of incarcerated ureteral calculi. Methods The clinical data of 56 cases of incarcerated ureteral calculi treated by ureteroscopic holmium laser were retrospectively analyzed from August 2007 to June 2009. 56 cases were associated with ipsilateral hydronephrosis, including 9 cases of distal ureteral calculi stenosis, 31 cases were complicated with polyps or granulation tissue package, 16 cases of external shock wave lithotripsy failed. Results, the lower stones in 42 cases were completely crushed 1, 2 weeks after the review, gravel discharge rate of 100%. The upper stones in 14 cases, 12 cases of 1 crushed, 2 weeks after the review, gravel discharge rate of 86%, 2 cases of stone fragments moved to the renal pelvis, double J tube after an extracorporeal shock wave lithotripsy, stone row net. 56 cases were followed up for 3 to 10 months, hydronephrosis were significantly reduced. Conclusion Ureteroscopic holmium laser lithotripsy for the treatment of incarcerated ureteral calculi is effective, safe and invasive. It is an effective and minimally invasive means to treat ureteral incarcerated stones, especially in the middle and inferior ureter.