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目的:探讨输尿管镜钬激光碎石术治疗输尿管上段结石的临床效果。方法:采用输尿管镜下钬激光碎石术治疗输尿管上段结石患者52例,其中双侧输尿管上段结石2例,共计左侧30例侧,右侧24例侧。结石大小(0.4～1.7)cm×(0.6～2.0)cm。结果:手术成功率98.1%,平均手术时间约28 min(17～65 min)。1例侧因输尿管口狭窄进镜困难改行开放手术。术后1个月复查,一次性碎石排净率为90.6%,5例侧有结石残留患者保留双J管行ESWL治疗,结石排出。术后3个月复查,所有患者患侧肾积水均明显减轻。结论:在熟练掌握输尿管镜操作技术的前提下,采用输尿管镜钬激光治疗输尿管上段结石是一种安全、有效的方法。
Objective: To investigate the clinical effect of ureteroscopic holmium laser lithotripsy in the treatment of upper ureteral calculi. Methods: Ureteroscopic holmium laser lithotripsy for upper ureteral calculi in 52 cases, including two cases of upper ureteral calculi in two cases, a total of 30 cases of left side and 24 cases of right side. Stone size (0.4 ~ 1.7) cm × (0.6 ~ 2.0) cm. Results: The success rate of operation was 98.1%. The average operation time was about 28 min (17 ~ 65 min). One case due to ureteral stricture into the mirror difficult to divert open surgery. One month after the operation, the disposable rate of gravel was 90.6%. Five patients with residual stones left double J tube ESWL treatment and the stones were discharged. 3 months after the review, all patients with ipsilateral hydronephrosis were significantly reduced. Conclusions: Ureteroscopic holmium laser treatment of the upper ureteral calculi is a safe and effective method under the premise of mastery of ureteroscopic techniques.