摘要
目的探讨输尿管镜钬激光碎石术治疗体外冲击波碎石(extracorporeal shockwave lithotripsy,ESWL)失败的输尿管上段结石的临床效果。方法回顾性分析应用输尿管镜钬激光碎石术治疗ESWL失败的输尿管上段结石78例患者资料。结果输尿管上段结石并发炎性息肉者67例(86%),碎石同时钬激光消融息肉。有输尿管扭曲、狭窄者16例(21%)。一次碎石成功63例,成功率81%。1周内结石排净46例,其余17例4周内结石排净。无输尿管穿孔、撕脱等严重并发症。11例结石冲回肾盂,经EWSL或经皮肾镜钬激光碎石术成功。4例置镜失败,行开放手术治愈。结论输尿管镜钬激光碎石安全有效,可作为ESWL治疗失败的输尿管上段结石首选治疗方法。
Objective To evaluate the efficacy of holmium laser lithotripsy for upper ureteral calculi after failed extracorporeal shockwave lithotripsy（ESWL）.Methods The data of 78 patients with upper ureteral calculi who were treated with ureteroscopic holmium YAG laser lithotripsy after failed ESWL were retrospectively analyzed.Results 67 cases（86%） were complicated with ploypi or granuloma tissues,which were melted by holmium laser simultaneously.21 cases（21%） were complicated with distal ureteral twist or stenosis.63 cases（81%） had calculi successfully crushed.Of all the patients,46 were stone free in 1 week and 17 in 4 weeks.No ureteral perforation or laceration was found.The calculi in 11 cases were flushed back into the pelvis,which were fragmented by ESWL or percutaneous nephroscopic holmium laser lithotripsy afterwards.Ureteroscope failed to pass through the stenosis in 4 cases,which received open surgery later.Conclusions Ureteroscopic holmium laser lithotripsy is effective and safe for upper ureteral calculi after failed ESWL and it should be considered as the first choice for the disease.
出处
《现代泌尿外科杂志》
CAS
2011年第2期120-122,共3页
Journal of Modern Urology
关键词
输尿管结石
输尿管镜
钬激光碎石术
体外冲击波碎石
ureteral calculi
ureteroscopy
holmium laser lithotripsy
extracorporeal shockwave lithotripsy（ESWL）
