输尿管镜钬激光联合两重双J管引流术处理ESWL治疗失败的输尿管结石

目的：评价输尿管镜钬激光碎石联合腔内两重双J管引流术处理ESWL治疗失败输尿管结石的临床疗效，并探讨其影响因素。方法：2005年1月～2010年6月对ESWL失败的21例输尿管结石患者行输尿管镜钬激光碎石术，碎石后置入两根双J管，术后常规留置2～4周后拔除。结石合并息肉形成的13例患者均同期采用钬激光汽化切割息肉。结果：21例输尿管结石行钬激光碎石成功率达95．2%（20／21），手术时间10～70min，平均（40．4±10．3）min；术后住院时间1～7天，平均（3．1土1．2）天。结论：输尿管镜钬激光碎石联合腔内两重双J管引流术处理ESWL治疗失败输尿管结石是安全可行的，保证结石清除率的同时不增加并发症发生率。

Ureteroscopic Ho:YAG Laser Lithotripsy with Simultaneous Two Double Pigtail Stents for Ureteral Calculi after Failed ESWL

Objective：To evaluate the clinical effect of ureteroscopic Ho ： YAG laser lithotripsy with simultaneous two double pigtail stents for ureteral calculi after failed ESWL and to investigate its influential factors. Methods：21 cases of ureteral calculi after failed ESWL were treated with ureteroscopic Ho ： YAG laser lithotripsy with simultaneous two double pigtail stents. Of them 13 cases had ureteral polyps and they underwent Ho ： YA- Glaser vaporization resection of the polyp. Two double-J stents were replaced 4 weeks after operation. Results： The overall success rate was 95.2%（20/21）,and the operating time was （10- 70） rain with a mean of （40.4±10. 3）min. Two cases of the failure group underwent open operation and the other one were treated by PCNL. Hospital stay was 1-7d with a mean of （3.1± 1.2）d. Conclusions： Ureteroscopic Ho ： YAG laser lithotripsy with simultaneous two double pigtail stents is an effective and safe management for after failed ESWL.