输尿管镜钬激光碎石术治疗输尿管结石96例分析

目的探讨输尿管硬镜钬激光碎石术治疗输尿管结石的有效性和安全性。方法回顾性分析2006年7月-2010年8月96例输尿管镜下钬激光碎石治疗输尿管结石患者的临床资料,对碎石率、排石率和并发症进行统计分析。结果 96例输尿管结石患者一次手术结石粉碎率为95.8%(92/96),输尿管镜置镜成功率为99.0%,输尿管上、中、下段碎石、排石成功率分别为81.8%(9/11)、97.1%(34/35)和99.0%(49/50)。在输尿管上段碎石过程中并发输尿管穿孔2例。全组均有不同程度的肉眼血尿,无输尿管撕脱、断裂等严重并发症发生。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D-J是安全和需要的。

Rigid Ureteroscopy with Holmium Laser Lithotripsy for Ureteral Calculi:a Report of 96 Cases

Objective To evaluate the efficacy and safety of rigid ureteroscopy with holmium laser lithotripsy for the ureteral calculi.Methods The clinical data of 96 patients with ureteral calculi treated by ureteroscopy with holmium laser lithotripsy from July 2006 to August 2010 were analyzed retrospectively.The rate of stone fragmentation,stone expulsion and complications were statistical analyzed.Results In all 96 cases,the one-time successful rate of stone fragmentation was 95.8%(92/96);the successful ratio of insertion of semi-rigid ureteroscope was 99.0%;the successful rate of stone fragmentation and expulsion were 81.8%,97.1% and 99.0% in the upper,middle and lower part of ureter,respectively.The ureter perforation occurred in 2 cases with stone in upper part of ureter.The hematuria with different degree was observed in all cases.No severe complications such as avulsion and rupture of ureter occurred.Conclusion The ureteroscopy with holmium laser lithotripsy is safe and effective for ureteral calculi,especially for the stones in the lower part of ureter.Double pigtail stent is a safe and useful adjunct for ureteroscopic lithotripsy.