摘要
目的回顾性分析输尿管镜下钬激光碎石取石治疗输尿管结石,总结治疗安全性及有效性,提高手术成功率。方法2007年8月～2008年6月,对112例输尿管结石患者进行输尿管镜下钬激光碎石取石术。64例（57.1%）患者结石位于输尿管下段,36例（32.1%）位于输尿管中段,12例（10.8%）位于输尿管上段。在术后2d及4-12周行腹部平片、超声检查或两者结合进行术后评估。碎石术后2d结石无残留被定义为单次结石完全清除。结果单次结石清除率为94.6%,其中中、下段输尿管结石清除率100%,上段结石清除率50%。6例（5.4%）在碎石后出现了并发症。2例出现输尿管穿孔,1例改开放手术,另外1例放置双J管结束手术后补救性ESWL。4例出现结石或部分碎石上移入肾盂加行补救性ESWL。结论输尿管镜下钬激光碎石取石治疗输尿管结石是安全和有效的,尤其对下段输尿管结石。术后常规放置双J管是安全和需要的。
[ Objective ] To retrospectively analyze the clinical outcomes of ureteroscopic lithotripsy for patients with uretal calculi and to evaluate the effectiveness and safety of holmium laser lithotripsy with a rigid ureteroscope. [ Methods ] A total of 112 patients with ureteral calculi underwent ureteroscopie holmium laser lithotripsy in our institution between August 2007 and June 2008. Calculi were located in the distal ureter in 64 patients （57.1%）, the midureter in 36 （32.1%）, and the proximal ureter in 12 （10.8%）. Patients were assessed 2 days and 4 to 12 weeks postoperatively with repeated plain radiography, uhrasonography, or their combinations. Complete removal of stone was defined as total clearance 2 days after the initial lithotripsy. [ Results ] The overall stone-free rate was 94.6% with the rate of 100% for calculi in the distal ureter （n =64）, and the midureter （n =36）, and 50% for calculi in the proximal ureter （n =12）. Complications occurred in 6 patients （5.4%）. UreteraJ perforation occurred in 2 patients, one was treated by open surgery and the other by conservative treatment with double-pigtail stent. And 4 patients with renal stones caused by the fragmentation of uretal stones were treated by external-corporal shock wave lithotomy （ESWL）. [ Conclusions ] This study suggest that ureteroseopic holmium laser lithotripsy is a safe, technically feasible and efficacious treatment for uretal stones, especially for those in the distal ureter and midureter. Double pigtail stent is a safe and useful adjunct for ureteroscopic lithotripsy, though many complications such as hematuria and renal pain may present after operation.
出处
《中国内镜杂志》
CSCD
北大核心
2009年第10期1094-1096,共3页
China Journal of Endoscopy
关键词
输尿管镜
输尿管结石
钬激光
uretemseopie lithotripsy
holmium laser
ureteral stone
