输尿管狭窄合并结石的腔镜治疗

目的 评价输尿管镜下钬激光治疗输尿管狭窄合并结石的疗效.方法 回顾性分析36例输尿管镜下钬激光治疗输尿管狭窄合并结石的临床资料.其中男26例,女10例,年龄26～65岁,输尿管中上段狭窄合并结石8例,输尿管下段狭窄合并结石28例.36例均行输尿管镜下钬激光切开输尿管狭窄并碎石治疗,术后随访6个月至1年,并于术后半年复查B超、尿路平片或静脉尿路造影.结果 36例手术均获成功,无中转开放性手术;手术时间20～45 min,平均30 min;术后住院时间3～5d;8例有术后低热,经抗感染治疗缓解,无输尿管撕脱、漏尿及大出血等严重并发症;术后随访,治愈32例（89％,32/36）,有效4例（11％,4/36）.结论 输尿管镜下钬激光治疗输尿管狭窄合并结石创伤小、并发症少、住院时间短、治愈率高,是一种简单有效的微创治疗方法.

Endoscopic management of ureticaleral stricture associated with calculi

Objective To evaluate the therapeutic effect of ureteroscopy with holmium laser on ureteral stricture associated with calculi.Methods The clinical data of 36 cases of ureteral stricture associated with calculi undergoing ureteroscopy with holmium laser treatment were analyzed retrospectively with 26 cases of male patients and 10 cases of female patients.The age was 26-65 years.There were upper and middle ureteral stricture associated with calculi in 8 cases,and lower segment of ureteral stricture associated with calculi in 28 cases.All the patients were treated with ureteroscopy with holmium laser.All cases were followed up for 6-12 months.In the follow-up of 36 cases B ultrasound and urinary tract flat piece or intravenous urinary tract imaging were performed to evaluate the therapeutic effect.Results Thirty-six patients underwent ureteroscopy with holmium laser successfully.No conversion to open surgery occurred.Mean operating time was 30 （20-45） min.Mean hospital stay postoperatively was 3-5 d.Postoperative 8 cases with low thermal,alleviated by the anti-infection treatment,no ureteral avulsion,leakage and severe complications such as hemorrhage.Postoperative follow-up,32 cases （89％,32/36） were cured and 4 cases （11％,4/36） were improved.Conclusion Ureteroscopy with holmium laser in treatment of ureteral stricture associated with calculi is a simple and effective minimally invasive method.